The role of diagnostics in tackling a global healthcare challenge

Antimicrobial resistance brings a considerable threat to people’s health across the globe.

Resistance is a natural biological phenomenon and arises when the organisms that cause infection evolve to survive treatments. The term antimicrobial includes antibiotic, antiprotozoal, antiviral and antifungal medicines.

Resistance is increased and accelerated by factors such as: misuse of medicines, for example over-prescribing of antibiotics; poor infection control; and global travel.

No new class of antibiotics has been discovered since the 1980s, so for most antibiotics there are few replacements or alternatives in the pipeline.

Statistics show that this healthcare challenge led to the death of about 1.27 million people globally in 2019 (Murray et al. The Lancet, 2022).

Innovative solutions are required to tackle the problem and advancing diagnostics has the potential to bring a resolution.

We know that the key to maintain efficacy or effectiveness of antimicrobials is antimicrobial stewardship - promoting the appropriate use of antimicrobials and preventing ‘over treating’.

However, one of the problems hindering good antimicrobial stewardship arises from the difficulty in quickly establishing the cause of infection i.e. if the infection is bacterial, viral, fungal, or more rarely parasitic.

Most medics will order tests, for example, cultures, nucleic acid amplification techniques, which allow the detection of an organism's genetic material in real-time, and microscopy to help determine what’s causing the patient’s infection.

But these routine methods can be quite slow, whilst decisions whether to prescribe antimicrobials can be needed quickly.? There’s often a lag between a decision to treat and the appropriate diagnostic information being available, which can lead to over-prescribing.

Increasing the speed, proximity, accuracy and cost effectiveness of a diagnostic tool are key components to reach an accurate and timely diagnosis and treatment.

An example of this is the diagnosis - including ruling out - of common respiratory tract infections, which is vital to prevent over prescribing.

This is something we’re looking at now in our lab, through testing a number of new diagnostics which are advancing capability to identify multiple viral microorganisms with very similar features, such as flu and Covid-19, using only one device. These infections cannot be treated with antibiotics and some patients may benefit from the early use of antiviral treatments.

We’ve used samples from our in-house biobank to research a number of innovative diagnostics for Covid-19, flu and RSV - a common respiratory virus that usually causes mild, cold-like symptoms.

Another challenge in antimicrobial stewardship is being able to provide accurate and cost-effective methods of identifying bacterial and fungal pathogens. We’ve been working with Microbira Ltd on a new method of identifying these infective microorganisms – by marrying spectroscopy and artificial intelligence, to create a ‘whole organism fingerprint’ which is unique to each microorganism. The system could potentially be cost-saving to healthcare systems, whilst reducing the spread of drug resistance by efficient identification and surveillance.

Our work in testing the effectiveness and usability of diagnostics which can help inform a clinician’s decision to treat with increased accuracy, speed and convenience, will ultimately improve patient outcomes and reduce the threat of antimicrobial resistance.

We offer integrated services with close working alongside colleagues in Novopath and hospital departments, to support all of our clients’ research and diagnostic needs.

Being part of Newcastle Hospitals gives us access to carry out usability studies directly with clinicians and patients in the type of environment the test is designed for.

We work closely with NIHR Newcastle MIC who engage with clinicians to guide the best point in the care pathway for a diagnostic to be used most effectively.

We have an open-door policy and are very happy to talk about how we can support and accelerate a wide range of diagnostic development work. Please get in contact at [email protected]

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