A fibre optic sensor can detect antibiotic-resistant bacteria in patient samples in under 20 minutes, compared to the current 1–3 days for standard lab cultures. This matters because slow diagnosis of antimicrobial resistance (AMR) directly kills patients. For sepsis, every hour of delay increases mortality. Current gold-standard testing requires expensive lab equipment and skilled staff, and misses certain resistance types—such as OXA-48 carbapenemase—because their weak enzymatic activity evades culture-based detection. The project targets carbapenem-resistant *E. coli*, *K. pneumoniae*, and *Pseudomonas aeruginosa*, which cause hospital-acquired infections that are now multi-drug resistant in 15% of cases in some settings. The NHS spends roughly £180 million annually on AMR. If successful, the platform would give clinicians a portable, low-cost tool to identify specific carbapenemase enzymes (KPC, VIM, OXA-48) at the point of care, with sensitivity below 1 picogram per millilitre. This could shift AMR testing from centralised labs to hospital wards and GP surgeries, enabling same-day targeted antibiotic treatment. The economic impact would come from reducing prolonged hospital stays, preventing spread of resistant infections, and cutting the need for expensive second-line drugs. The underlying fibre-optic sensing technology could also be adapted for other infectious disease diagnostics.
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Antimicrobial resistance (AMR) is a significant economic burden to NHS; costing the UK government ~£180 million annually. It also presents a vital detriment to human welfare and health. Diagnose and treating AMR represent significant challenges in health care industry globally. However, there is an opportunity to develop disruptive approaches to identifying AMR at earlier stage, to guide doctors to treat patient. Current AMR testing methods include (1) culture-based technology, polymerase chain reaction (PCR), (2) DNA microarray, and (3) whole-genome sequencing and metagenomics. Culture-based method is the golden standard in clinic testing, however it suffers disadvantage of long operation time (typically 1-3 days), which significantly delays treatment to patients and thus results in increased mortality (such as sepsis patient). All above tests require dedicated clinical laboratory, expensive instrument and highly skilled staff. Significant concerns have been raised on the rising of carbapenem-resistant Enterobacteriaceae including K. Pneumoniae and E. Coli due to the acquisition of carbapenemase. The rate of hospital-acquired carbapenem-resistant Enterobacterale infection was 15% and all carbapenemase-producing Enterobacterale were multi-drug resistant in a recent report from Ethiopia. The carbapenemase-producing E. Coli and K. Pneumoniae are also reported in hospital-acquired infection in UK. Developing sensitive and affordable method to test for such resistance is a key for early diagnosing the carbapenem resistance infection among patient with hospital-acquired infection. In addition to K. Pneumoniae and E. Coli, other bacteria such as Pseudomonas Aeruginosa can also gain the trait and exhibit resistance not only to b-lactam, but also to other groups of antibiotics. Carbapenemase can be recognized to several classes including class A (KPC), Class B (VIM, IMP, NDM) and class D (OXA-48). NDM and KPC are the two most prevalent carbapenemases in many countries including UK, while OXA-48 type carbapeneses are the most challenging resistant mechanisms for clinical detection using the culture method due to their weak enzymatic activity. VIM commonly present in the Enterobacteriaceae but also highly prevalent in non-glucose-fermenting bacteria such as Pseudomonas aeruginosa. There is an urgent need in developing a low cost, high sensitivity, easy to operate sensing system for early detection of these microbials and stopping their spreading. The overarching aim of the project is to develop a fast-response, ultra-sensitive and affordable fibre optic biosensor platform for rapid point of care test (POCT) of antimicrobial resistance with reasonable cost. The specific objectives of this project are: Optimisation of antibodies' functionalization process with a very high binding efficiency. Develop data processing algorithm for automatic reading of portable demodulation system. Demonstration of the fast detection (<20 minutes) of KPC, VIM and OXA-48 in biological samples, with a LoD under 1 pg/mL. Applying the developed TFI biosensor for clinic AMR test, and verifying it using commercial test methods. The success of this project will benefit researchers working in all diagnostics fields in which extremely high sensitivity is required, or where measurements are used in models or meta-analyses. This project will benefit the medical diagnostic industry in general by providing an accurate, easy-to-use tool for fast AMR diagnostics, and supporting public health. This will relieve the economic burden on NHS for effective treatment of patients and save lives.
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