Phenotypic Antimicrobial Susceptibility Testing Based on Nucleic Acid Analysis

Author: Schoepp, Nathan Garrett

Year: 2019

Degree: Dissertation (Ph.D.)

Advisor: Ismagilov, Rustem

Committee Members: Heath, James R.; Tirrell, David A.; Leadbetter, Jared R.; Ismagilov, Rustem F.

Option: Chemistry

DOI: 10.7907/5F6B-F452

Abstract

Antimicrobial resistance (AMR) is one of the most widely recognized threats to global health, and one that continues to grow as new mechanisms of resistance evolve and resistant pathogens spread. Antibiotics are a cornerstone of modern medicine, but their misuse and overuse has constantly and consistently reduced their efficacy to the critically low levels we observe today. As a result, the rate of mortality as a direct result of AMR is approaching over a million deaths annually, with 20-year projections in the ten-millions. Rapid, phenotypic antimicrobial susceptibility testing (AST) that could be performed at the point of care (most notably in ≤ 30 min) would decrease the overuse of antimicrobials, allow physicians to make informed choices about which antimicrobials to prescribe, and improve patient outcomes. Today no such method exists. The ultimate goal of the below work is to allow physicians to choose, instead of guess, which antibiotics to use. We envision that development of these tests into distributable diagnostics will drastically improve patient outcomes, curb the spread of resistance, strengthen global antibiotic stewardship, and forestall the post-antibiotic era.

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