A smart sensor for monitoring antimicrobial interventions in wound infections

Effective therapeutic monitoring of wound infections is crucial for wound care. We explore a novel approach using a previously described 3D-printed, colourimetric indicator to non-invasively monitor antimicrobial interventions in wound infection. The indicator contains a pH-sensitive dye which detects carbon dioxide production from wound pathogens by changing colour from blue to yellow. The sensor accurately reported the minimum inhibitory concentration of antibiotic against Pseudomonas aeruginosa in a sealed 96-well plate. Subinhibitory antibiotic concentrations resulted in the sensor changing colour, whilst remaining blue for inhibitory concentrations. The sensor was applied to a porcine skin wound model with Pseudomonas aeruginosa biofilms, testing several antimicrobial treatments: antibiotic monotherapy, phage monotherapy, and a combination of both. After treatment, the sensor, sealed with the wound, enabled visual monitoring of antimicrobial efficacy. Through comparing post-treatment bioburden and sensor response, greater log-fold reductions in P. aeruginosa following antimicrobial treatment correlated with longer sensor response times. Sensors monitoring unsuccessfully treated biofilms changed colour, while those treated at or above the minimum biofilm eradication concentration elicited no colour change, indicating P. aeruginosa eradication. This sensor holds promise for monitoring wound infection treatment efficacy, improving patient outcomes, and promoting undisturbed wound healing as a non-invasive point-of-care tool.