Abstract
A label-free, rapid, and easy-to-use lateral flow electrochemical biosensor was developed for urinary tract infection (UTI) diagnosis in resource challenged areas. The sensor operates in non-faradaic mode and utilizes Electrochemical Impedance Spectroscopy for quantification of Prostaglandin E2, a diagnostic and prognostic urinary biomarker for UTI and recurrent UTI. To achieve high sensitivity in low microliter volumes of neat, unprocessed urine, nanoconfinement of assay biomolecules was achieved by developing a three-electrode planar gold microelectrode system on top of a lateral flow nanoporous membrane. The sensor is capable of giving readouts within 5 min and has a wide dynamic range of 100–4000 pg/mL for urinary PGE2. The sensor is capable of discriminating between low and high levels of PGE2 and hence is capable of threshold classification of urine samples as UTI positive and UTI negative. The sensor through its immunological response (directly related to host immune response) is superior to the commercially available point-of-care UTI dipsticks which are qualitative, have poor specificity for UTI, and have high false-positive rates. The developed sensor shows promise for rapid, easy and cost-effective UTI diagnosis for both clinical and home-based settings. More accurate point-of-care UTI diagnosis will improve patient outcomes and allow for timely and appropriate prescription of antibiotics which can subsequently increase treatment success rates and reduce costs.
Highlights
Urinary tract infection (UTI) is defined as infection in any part of the urinary tract with a pathogen resulting in inflammation [1,2]
To improve on the current state-of-the-art of UTI POC diagnostics, we propose a lateral flow based electrochemical biosensor dipstick that can diagnose UTI by quantifying the levels of Prostaglandin E2 (PGE2) in urine
Artificial urine was prepared using the recipe (MP-AU or Multipurpose-Artificial urine) by Sarigul et al and all the dilutions were prepared in deionized water [17]
Summary
Urinary tract infection (UTI) is defined as infection in any part of the urinary tract with a pathogen (mainly bacteria) resulting in inflammation [1,2]. National Healthcare Safety Network (NHSN), UTI is among the most common health care related infections to be reported [2] and is one of the leading reasons for treatment in primary care settings [4]. There is a 50–80% chance that a woman has UTI if she presents to a primary care clinic with typical symptoms [4,6]. The current gold standard for UTI diagnosis is lab-based culture of mid-stream clean-catch urine when clinical symptoms develop [4]. The diagnostic window of clinical urine culture is typically 2–3 days. This long wait time is primarily due to (i) the time required for Chemosensors 2021, 9, 271.
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