Richards-Kortum, Rebecca2019-05-172020-05-012019-052019-04-17May 2019Majors, Catherine Elizabeth. "Detecting Sepsis: Low-Cost, Point-of-Care Laboratory Tests for Maternal and Neonatal Sepsis in Low-Resource Settings." (2019) Diss., Rice University. <a href="https://hdl.handle.net/1911/106010">https://hdl.handle.net/1911/106010</a>.https://hdl.handle.net/1911/106010This thesis describes my work to develop devices to detect bacterial infections at the point of care. Neonatal and maternal sepsis are leading causes of death in low-resource settings. However, diagnosis based on symptoms alone can be challenging because symptoms are often non-specific. However, early diagnosis and onset of treatment have been shown to be a determining factor in reducing mortality and morbidity. This thesis describes two tools to help clinicians detect and manage maternal and neonatal sepsis rapidly at the point of care. A white blood cell count and differential is an important clinical laboratory test; together with clinical signs and symptoms, it can be used to help differentiate between viral and bacterial infections, to assess the effectiveness of an antibiotic treatment, and to predict clinical outcomes. This thesis describes a new device, The LeukoScope, to measure a white blood cell count and neutrophil count with a drop of blood. The LeukoScope consists of a disposable cartridge that fluorescently stains the white blood cells in a whole blood sample and a battery powered reader that contains a custom fluorescence microscope and software to analyze images and report the white blood cell and neutrophil counts to the user in under 5 minutes. The LeukoScope’s performance was first assessed in oncology patients at the Lyndon B. Johnson hospital in Houston, TX. Performance of the LeukoScope was shown to be comparable to commercial point-of-care alternatives. LeukoScope performance was then assessed in pediatric and neonatal samples at Queen Elizabeth Central Hospital in Blantyre, Malawi where accurate performance was demonstrated in low and normal WBC count ranges in both sample populations. Detecting protein biomarkers of sepsis is a promising alternative to current methods of culturing pathogens in order to rapidly detect the presence of an infection. This thesis describes work to develop a lateral flow immunoassay to quantitatively measure the concentrations of two well-characterized biomarkers of bacterial sepsis: C-reactive protein and procalcitonin. The assay runs in less than 10 minutes and can detect concentrations of C-reactive protein and procalcitonin across the clinically relevant range.application/pdfengCopyright is held by the author, unless otherwise indicated. Permission to reuse, publish, or reproduce the work beyond the bounds of fair use or other exemptions to copyright law must be obtained from the copyright holder.SepsisMaternalNeonatalDiagnosticWhite Blood CellNeutrophilFluorescenceImagingBiomarker DetectionProcalcitoninC-Reactive ProteinThesis2019-05-17