Smart Wound Dressing with Real-Time Colorimetric Detection of Antimicrobial Resistance and Infection.

Abstract

The increasing prevalence of wound infections and antimicrobial resistance (AMR) highlights the urgent need for advanced solutions that go beyond traditional antibiotic therapies, which could combine innovative treatment with diagnostic tools. This study presents a multifunctional smart wound dressing, integrating an antimicrobial wound-contacting layer with a chromogenic hydrogel system for real-time detection of infections and AMR. The dressing consists of electrospun poly(ε-caprolactone) (PCL) fibers functionalized with ionic silver anchored to quaternary ammonium moieties, offering potent antibacterial activity. It is coupled with two chromogenic substrates, targeting crucial intracellular enzymes: (i) chlorophenol red-β-d-galactopyranoside (CPRG) for β-galactosidase-based rapid colorimetric detection of pathogenic infections and (ii) nitrocefin for identifying β-lactamase-mediated AMR. Extensive in vitro and ex vivo studies with these chromogens show rapid color-change responses and precise AMR identification. The direct colorimetric method eliminates the need for sophisticated equipment, trained personnel, or lengthy laboratory analyses. Additionally, the results are integrated with the Internet of Things (IoT), which decodes the color changes, enabling the healthcare providers to access the real-time infection status. This innovative dressing aids timely interventions, reduces reliance on traditional antibiotics, and addresses AMR challenges, making it highly suitable for point-of-care (POC) applications, including in resource-limited settings.