Rapid detection of antimicrobial resistance

Phenotypical detection of antimicrobial resistance in bacteria

Breaking news ! 

Molsid achieves the first rapid phenotypic diagnostic test for AMR on primary clinical samples. Pre-clinical trials on urinary tract infections show that all beta-lactamase and carbapenemase enzyme activities can be detected in resistant E.coli strains

Antimicrobial resistance

A growing number of bacteria resist almost all antibiotics => this is AMR = Antimicrobial Resistance

Since their discovery, antibiotics have helped eradicate several infection-based diseases that had inflicted untold suffering on humanity. Today, the efficacy of antibiotics is jeopardized by the emergence of bacterial resistance to antibiotics. Health agencies now frequently alert the public to the discovery of a growing number of resistant strains at the origin of major diseases, strains that even resist the latest in antibiotics innovation.

Antimicrobial resistance is a major and growing public health issue. If nothing is done, more than 10 million people will die each year from AMR by 2050 (source: WHO).

By 2030, AMR could force up to 24 million people into poverty and by 2050, AMR could cause more deaths than cancer, cholera, and diabetes combined. (source: WHO)

AMR is especially a concern in the hospital environment. It is responsible for nosocomial outbreaks, longer hospital stays and therefore increased healthcare costs and the deterioration of prognostic outlook for patients, especially in intensive-care units where time matters.

“It is a super-pandemic, as it comprises a whole bunch of diseases. It is the mother of pandemics.” M. Zaman, Boston University

Early detection of antimicrobial resistance is key to improved therapeutic treatment of patients infected by certain pathogenic bacteria such as nosocomial agents, known to present multiple resistances to antibiotics. A serious problem in an epidemic context is a propagation due to delayed identification of patients harbouring resistant strains.

Antimicrobial susceptibility testing (AST)

Many rapid diagnostic techniques allow for pathogen identification and some of them can also detect the presence of resistance-related genes or proteins. However, most AST products require the initial clinical sample to be processed by bacterial culture. This significantly slows the workflow until a decision can be made which antibiotic is well suited for treatment.

Today modern AST techniques include technologies based on nucleic acid amplification (PCR), whole genome sequencing, and hybridization as well as immunodiagnostic and mass spectrometry-based methods and biosensor-based AST.

Each method has various benefits and limitations, especially in terms of time-to-decision, sample preparation and precision.

Molsid’s PYTHIA is the first phenotypic test combining the following benefits:

  • Clear results in under 2 hours
  • NO bacterial culture needed
  • Operates directly on clinical samples (urine, saliva, CSF, swab…)
  • Quantitation of AMR level
  • Small and easy-to-use PoC/MD

Pre-Clinical Trials on Urinary Tract Infections, 960 assays performed

Exceptional Specificity on Primary Clinical Samples

14 out of 15 enzyme activities detected = 98% of EU AMR cases in 2020

Unprecedented Sensitivity & AMR Quantitation

Pre-Clinical Trials on Urinary Tract Infections, 960 assays performed


The graphic shows typical results obtained using our dedicated fluorescence reader (link). Centrifugation allows to concentrate the fluorescent signal generated by the entire clinical sample in the form of a fluorescent pellet. This ensures PYTHIA’s exceptional detection sensitivity. It further permits the quantitation of bacterial count with a threshold of only one thousand bacteria per milliliter of urine, an unprecedented value for primary clinical samples, and this at an astonishingly short incubation time (1 hour).

We are proud to call the following institutions our partners in the development of PYTHIA:

Phenotypic detection of antimicrobial resistance in bacteria

Our molecular probes detect enzyme activity produced by microorganisms.  Molsid’s PYTHIA test allows for the phenotypic detection of bacterial resistance to beta-lactams and carbapenems in less than 2 hours as opposed to 48 hours with conventional methods.

SmartID Green probe for β-lactamase :

This probe is designed to detect bacteria that produce beta-lactamase activity, a class of enzymes responsible for the resistance to beta-lactams, a broad class of antibiotics. Beta-lactams comprise penicillins, cephalosporins, monobactams, carbapenems and beta-lactamase inhibitors. They are the reference treatment for pneumococcal infections.

SmartID Green probe for carbapenemase:

This probe is designed to detect bacteria that produce carbapenemase activity. Carbapenemases are responsible for the resistance to carbapenems. This resistance occurs mainly in Gram-negative pathogens such as Klebsiella pneumoniaePseudomonas aeruginosaAcinetobacter baumannii, as well as in Enterobacteriaceae.

Contrary to conventional fluorogenic enzyme-responsive probes, Molsid’s SmartID probes generate localized fluorescence, i.e. fluorescence that does not diffuse away from the site of the targeted enzyme activity. This allows for precise, unambiguous discrimination of positive from negative cells.

Molsid develops the fastest and most accurate phenotypic test for quantitative AMR diagnostics directly on clinical primary samples.

  • Rapid test (less than 2 hours) providing quantitative results
  • Exceptional specificity, unprecedented sensitivity
  • Small desktop device, affordable and cost-efficient
  • Directly usable on primary sample: no culture, no amplification, no purification
  • Easy-to-handle: no training needed, manipulation time less than 5 minutes