Intraoperative pathogen rapid detection on chip.

During surgery, purulent fluid containing pathogens may be found at the surgical site. Pathogens in purulent fluid can cause sepsis if disseminated into the bloodstream. Therefore, intraoperative detection of pathogens in purulent fluid is critical for guiding surgeons in selecting surgical management and antibiotic therapy. However, current detection methods are either time-consuming or unable to identify live pathogens, restricting their clinical application in intraoperative settings. To overcome these limitations, we proposed an intraoperative pathogen rapid detection (IPRD) method. This method can simultaneously detect the presence, viable fraction, species, and concentrations of multiple pathogens in 15 min. This method is performed on a chip with two parts: a single-channel part combines live/dead staining with AI-assisted microscopy to quantify live pathogens, and a parallel-channel part uses electroporation-based lysis followed by LAMP assay for nucleic acid detection. This method demonstrated an accuracy of 99.01 % in clinical validation, reliably detecting Candida albicans, Escherichia coli, and Enterococcus faecalis at 103 CFU/mL. The IPRD method has potential applications in various infection-prone surgeries, offering timely pathogenic information to assist surgeons in making surgical decisions.