Lay summary
We are proposing to completely change how bacterial resistance is detected – saving patient lives and healthcare resources. The sensitivity testing will be done in the patient with the results being detected at the patient’s bedside using a simple assay that does not require access to laboratory facilities. This real time in situ testing involves treating the patient with a test dose of antibiotic delivered in a nanoparticle along with an inactive reporter. If bacteria are drug sensitive they will upregulate a number of enzymes, one of which will activate the reporter. The activated reporter will then be detected in a drop of blood taken from the patient using a highly sensitive assay, similar to glucose testing. Providing clinicians with a method for determining antibiotic resistance at the bedside in a timely fashion will transform how antibiotics are used, allowing them to move from empirical to evidence-based treatment of disease.