Droplet digital PCR (ddPCR) is the first commercially significant application of droplet microfluidics [
4]. As a powerful technology allowing absolute nucleic acid quantitation, ddPCR has been widely adopted in the detection of pathogenic microorganisms [
59]. ddPCR involves partitioning PCR solution into tens of thousands of nanoliter droplets, with the requirement that each droplet contains either "one" or "zero" target nucleic acid (
Fig. 3b) [
60]. Droplets are then amplified individually, and the concentration of target nucleic acid can be obtained by counting the number of positive (fluorescent) droplets at the end point and calculating based on Poisson statistics [
61]. ddPCR is independent of external standard calibrations and exhibits higher sensitivity and precision compared to quantitative PCR (qPCR). Recently, it has been successfully applied to quantify various bacterial species in diverse samples [
62-
65], such as
Lactococcus lactis group during milk fermentation [
66],
Listeria monocytogenes recovered from biofilms [
67], total coliforms and
E. coli in urban water [
68], and
Helicobacter pylori in stomach and stool samples [
69]. Besides specific bacteria detection, ddPCR could be combined with gene sequencing to provide a quantitative framework measuring absolute abundances of individual bacterial taxa in complex communities [
70-
72]. ddPCR was utilized to measure the total amount of 16S rRNA gene copies, which represented the total microbial load in the sample, and 16S rRNA gene sequencing offered the relative abundance of each taxon; the absolute abundances of taxa were calculated by multiplying the total load with the relative abundance. Absolute instead of relative microbial abundances could provide more accurate analyses of changes in taxa among different samples. This framework has been applied to determine the differential effects of diet on each taxon in murine lumenal and mucosal samples along the gastrointestinal (GI) tract [
71]. ddPCR is also advantageous for early diagnosis of viral infection [
73-
77]. For example, Dong
et al. reported the rapid detection of fowl adenovirus serotypes 4/10 (FAdV-4/10) [
78]. Compared to conventional PCR detection, ddPCR exhibited 1000-fold higher sensitivity. This assay may serve as a tool for detection of FAdV-4 contamination in live-attenuated vaccines. Jiang
et al. introduced the design and implementation of an automatic, integrated instrument with a built-in power supply for continuous-flow ddPCR, as demonstrated by absolute quantitation of hepatitis B virus (HBV) in serum samples [
79]. The Shen group developed a portable self-partitioning SlipChip (sp-SlipChip) microfluidic device for quantification of BK virus (BKV) DNA [
80]. A major feature of this method is a "chain-of-pearls" microchannel, with which individual droplets for PCR reactions are generated in a robust and reproducible manner through a slip-induced self-partitioning mechanism (
Fig. 3c). As a result, this system allows for "sample-to-digital-result" detection, making it ideal for point-of-care analysis. Earlier, the group also utilized this droplet formation strategy for digital loop-mediated isothermal amplification (LAMP) quantification of human papillomavirus (HPV) DNA [
81].