Rapid antimicrobial susceptibility testing directly from positive blood cultures.

Sepsis results from bloodstream infections and is a leading cause of mortality worldwide, accounting for over 10 million deaths annually and imposing a substantial burden on the global economy. Septic shock is a time-sensitive condition in which mortality increases by approximately 8% for every hour of delayed treatment. A key limitation in current sepsis management is the delayed initiation of targeted antimicrobial therapy, primarily due to time-consuming subculturing steps and slow antimicrobial susceptibility testing (AST) methods. In this study, we present a rapid AST workflow performed directly from positive blood cultures within 3 hours. The method integrates a Smart Centrifugation Device for host cell removal and bacterial concentration, with impedance-based flow cytometry (iFAST) for rapid antimicrobial susceptibility testing. This streamlined, partially automated method has the potential to accelerate sepsis diagnosis and facilitate timely, targeted antimicrobial treatment.