作者
KC Tjandra, N Ram-Mohan, M Roshardt, E Zudock, Z Qu, KE Mach, O Eminaga, JC Liao, S Yang, PK Wong
发表日期
2022/11/4
简介
Multidrug-resistant Enterobacteriaceae are among the most urgent global public health threats associated with various life-threatening infections. In the absence of a rapid method to identify antimicrobial susceptibility, empirical use of broad-spectrum antimicrobials such as carbapenem monotherapy has led to the spread of resistant organisms. Rapid determination of antimicrobial resistance is urgently needed to overcome this issue. By capturing dynamic single-cell morphological features of over thirty-nine thousand cells from nineteen strains of Klebsiella pneumoniae, we evaluated strategies based on time and concentration differentials for classifying its susceptibility to a commonly used carbapenem, meropenem, and predicting their minimum inhibitory concentrations (MIC). We report morphometric antimicrobial susceptibility testing (MorphoAST), an image-based machine learning workflow, for rapid determination of antimicrobial susceptibility by single-cell morphological analysis within sub-doubling time. We demonstrated that our algorithm has the ability to predict MIC/antimicrobial susceptibility in a fraction of the bacterial doubling time (< 50 min.). The classifiers achieved as high as 97% accuracy in 20 minutes (two-fifths of the doubling time) and reached over 99% accuracy within 50 minutes (one doubling time) in predicting the antimicrobial response. A regression model based on the concentration differential of individual cells from nineteen strains predicted the MIC with 100% categorical agreement and essential agreement for seven unseen strains, including two clinical samples from patients with urinary tract infections with different …