Towards next-generation AMR surveillance: Assessment of novel technologies with high-throughput and multiplexing potential
( TEXAS )

Various genetic approaches are used for AMR surveillance, but there are few harmonized, high-throughput platforms that target clinically relevant markers that indicate AMR mobility and multidrug resistance (MDR). Here we will develop and validate two promising technological platforms that can be readily incorporated into national and international integrated surveillance programs. Our digital droplet PCR platform will provide a highly sensitive unbiased method of resistance gene (ARG), mobile genetic element, and taxonomic gene co-occurrence in complex environments. This approach allows genetic source tracking of clinically relevant MDR pathogens in regions with suitable analytical facilities. In tandem, our multiplexed DNA-based electrochemical biosensor platform will facilitate on-site multiplexed quantification of MDR markers, which reduces the need for expensive analytical equipment and highly trained staff. This will be invaluable for AMR surveillance in low-resource regions. Both technological platforms will integrate taxonomic, ARG and mobility markers inferred from microbiological, epidemiological, and environmental data generated by the consortium. The diverse and multidisciplinary TEXAS team includes experts on technology development as well as policy guidance to international organizations on central to global integrated surveillance planning. This will promote adoption of selected targets, and implementation of the two platforms (validated against gold standard methods) for samples collected from low- and high-resource settings and differing sectoral contexts