CRISPR-Based Point-of-Care Diagnostics for Antimicrobial Resistance: From Molecular Precision to Clinically Deployable Bioengineering Systems

The issue of antimicrobial resistance (AMR) has become a defining feature of global health, driven not only by microbial evolution but also by persistent delays in delivering actionable diagnostic information to clinicians. Although molecular technologies have significantly enhanced pathogen characterization, their clinical utility remains constrained by centralized infrastructure, lengthy turnaround times, and limited accessibility in resource-restricted settings. Based on programmable guide RNAs and the collateral cleavage activity of Cas enzymes, CRISPR-based nucleic-acid diagnostics have rapidly evolved into point-of-care (POC) testing applications. However, analytical sensitivity is no longer the primary barrier to clinical translation; instead, challenges related to engineering robustness in complex biological matrices, multiplex resistance detection, workflow automation, reagent stability, and clinical performance have become dominant. This Perspective re-evaluates CRISPR-based AMR testing as an integrated bioengineering system rather than a single molecular assay. We trace key translational bottlenecks and propose system-level benchmarks required to transition CRISPR diagnostics from experimental platforms into clinically deployable tools supporting antimicrobial stewardship and surveillance programs.