Infectious diseases represent a significant healthcare cost burden. For bacterial infections, especially chronic ones, antibiotics are selected for treatment not knowing whether the drugs selected are appropriate for the infecting pathogen. Although viral infections have few effective treatments, patients desire medication before they leave their primary care physician's office. Antibiotics are often prescribed for viral infections because the patient demands them not realizing they are ineffective, or the physician provides them as a precautionary measure. Clearly, rapidly and accurately identifying infectious pathogens will lead to fewer unnecessary prescriptions, reduced hospitalization time, and a reduction in the spread of antibiotic resistant microbes. We propose to develop a genetic analysis microfluidic system that uses a single pneumatic input for fluidic control, and a multiplexed reaction system for species identification. The device will use a series of reaction chambers followed by a separation channel to determine the class of infecting agents and their specific resistance to antibiotics. We will target pathogens associated with acute (the common cold) and chronic (multiple-species bacterial) respiratory infections for our main applications. We choose these target areas for several reasons. First, for our strategy of small device size, we need a sample with sufficient pathogenic load to complete an analysis patient material from a swab, sputum, or nasal wash for these diseases typically has high pathogen numbers. Second, understanding the different pathogen species and strains and their infection time course could lead to better treatment and lower the use of antibiotics. Finally, the device can easily be extended to other viruses, bacterial agents, or genomic analysis with merely a change in the reagents.
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