Toward Enhanced Selection of Antibiotics in a Hospital Laboratory—Development of a Rapid Electrochemical Antimicrobial Sensitivity Test for Urinary Tract Infections

Antimicrobial resistance poses a major global health threat, often driven by empirical antibiotic use due to the relatively slow (24-72 h) diagnostic pathway for urinary tract infections (UTIs). Due to their low cost and ease of multiplexing, electrochemical biosensors offer a promising alternative. Herein, we report on the Microplate Dx RapidPlate platform, a rapid electrochemical impedance spectroscopy (EIS)-based approach for accelerated antibiotic susceptibility testing (AST) directly from urine samples, without pre-treatment. This report charts the evolution of the core EIS-based AST measurement from a laboratory prototype into a fully realized <i>Alpha</i> prototype platform with an accompanying 32-channel electrochemical cartridge designed specifically for interrogation of urine samples. A total of 89 clinically derived urine samples were evaluated at three clinical sites (U.K. and India), with results compared against standard methods (VITEK 2 and disk diffusion). The impedance-based RapidPlate system detected bacterial growth within 50 min and provided susceptibility profiles by 85 min, with 95% concordance to reference tests. Consistent performance was demonstrated across diverse clinical settings and organisms, including <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i>. The RapidPlate AST system has demonstrated great potential as a cost-effective, point-of-care tool for rapid AST, supporting and improving UTI management and antimicrobial stewardship.