Carbapenemase-producing Enterobacteriaceae (CPE) are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization (WHO). Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and laborious. We have developed a magnetic digital microfluidic (MDM) platform, known as MDM Carba, for the identification of CPE by measuring their ability to hydrolyze carbapenem antibiotics. MDM Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic testing. On the MDM Carba platform, tests are performed in droplets that function as reaction chambers, and fluidic operations are accomplished by manipulating these droplets with magnetic force. The simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on operation. Because of the unique “power-free” operation of MDM technology, the MDM Carba platform can also be operated manually, showing great potential for point-of-care testing in resource-limited settings. We tested 27 bacterial isolates on the MDM Carba platform, and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP test. MDM Carba may shorten the overall turnaround time for CPE identification, thereby enabling more timely clinical decisions for better clinical outcomes. MDM Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.

产碳青霉烯酶肠杆菌科(CPE) 是一组耐药革兰氏阴性病原体，被世界卫生组织 (WHO) 列为严重威胁。检测抗生素耐药病原体的传统方法无法评估耐药机制，并且往往费时费力。我们开发了一种磁性数字微流体 (MDM) 平台，称为 MDM Carba，用于通过测量 CPE 水解碳青霉烯类抗生素的能力来识别 CPE。与传统表型测试相比，MDM Carba 能够快速测试 CPE 并减少试剂用量。在 MDM Carba 平台上，测试在充当反应室的液滴中进行，并通过磁力操纵这些液滴来完成流体操作。简单的基于液滴的磁流体操作可实现轻松的系统自动化和简化的手动操作。由于MDM技术独特的“免电源”操作，MDM Carba平台也可以手动操作，在资源有限的环境中显示出床旁检测的巨大潜力。我们在 MDM Carba 平台上测试了 27 种细菌分离株，结果显示灵敏度和特异性与广泛使用的 Carba NP 测试相当。 MDM Carba 可以缩短 CPE 识别的总体周转时间，从而实现更及时的临床决策，以获得更好的临床结果。 MDM Carba 是一个技术平台，只需稍加修改即可进一步开发，以改善其他类型抗生素耐药性的诊断。