Tag Archives: Bacterial Infections

Rapid diagnostic tools needed to fix antibiotic crisis, says review

New rapid diagnostic tools are needed to stop the unnecessary use of antibiotics and tackle superbugs, a government review has said.

Fundamental change is required to make a dent in the huge number of antibiotic prescriptions given mistakenly for viral infections, according to the report.

Creating more refined tests – which will allow doctors to identify in minutes the strain of bacterial infection present and the antibiotics to which it is resistant or susceptible – will allow more precise prescribing of narrow-spectrum antibiotics, it said.

Jim O’Neill, the economist and former chairman of Goldman Sachs Asset Management who is leading the Review on Antimicrobial Resistance set up by David Cameron in July 2014, said: “For far too long we have not recognised the huge cost to society of increasing resistance when we use antibiotics that we don’t need, such as taking antibiotics for flu, which have no effect except to increase the chances of superbugs developing.

“To avoid the tragedy of 10 million people dying every year by 2050, the world needs rapid diagnostics to improve our use of antibiotics. They are essential to get patients the right treatment, cut down on the huge amount of unnecessary use and make our drugs last longer.”

The review highlighted a study that found that more than two-thirds of courses of antibiotics in the US – equivalent to 27m – were likely to have been inappropriately prescribed for conditions that were not infections at all, or were caused by viruses.

The report, the latest in a series by the review – which will publish final recommendations in spring next year, suggested that rapidly advancing technology in the shape of computer learning and artificial intelligence could be put to good use in changing antibiotic prescribing.

But it cautioned that a step-change in behaviour is needed to alter long-established ways of using antibiotics.

One problem the review identified was that it is more expensive and more time-consuming for a doctor or a patient to use a diagnostic than to use a drug just in case it is needed, even if the wider consequences are negative.

For instance, in the UK, the world’s “last-line” treatment is given on a precautionary basis to almost all patients with gonorrhoea, even though 70% to 80% of the cases would likely respond to older, abandoned first-line treatments.

The committee also pointed out that drug companies have no commercial interest in the advent of rapid diagnostics, which would limit the number of antibiotics prescribed.

To bridge the mismatch between costs and benefits, it proposes a market-based revenue stream for developers of products that would top up payments to developers to make sure the commercial benefits and the needs of society are better aligned.

It also called for more money to be pushed into early-stage research, referencing its previous report, which proposed a global AMR innovation fund of around $2bn over five years to help boost funding for blue-sky research.

The report concluded by saying the long-term economic case for rapid diagnostics should be made, with healthcare systems playing an important role in this.

Dr Margaret Chan, director general of the World Health Organisation, said: “Antibiotics are rarely prescribed based on a definitive diagnosis. Diagnostic tests can show whether or not an antibiotic is actually needed, and which one. Having rapid, low-cost and readily available diagnostics is an essential part of the solution to this urgent problem.”

Source The Guardian

Toolkit to help fight bacterial infections

Antibiotic-resistant bacterial infections could be better controlled by nurses and other health staff, thanks to the launch of a new toolkit from specialists at Public Health England (PHE).
The toolkit will help hospitals identify, manage and control such viruses caused by carbapenemase-producing Enterobacteriaceae (CPE).
CPEs are strains of gut bacteria that have the ability to kill a key group of antibiotics called carbapenems, making them resistant to these drugs.
Two trusts in Manchester have seen CPE strike over 100 patients during the past five years.
A Patient Safety Alert has been issued to encourage take-up of the anti-bacterial infection toolkit.
The alert, devised by PHE and NHS England, urges trusts to immediately identify if there are, or have been, cases of CPE in their organisation.
The alert also recommends introducing the development of a CPE management plan at board level.
It says that managing cases or outbreaks of antibiotic resistant infections in hospitals necessitates four crucial elements:
:: samples taken early for microbiological analysis if there is a suspicion that a patient is infected with resistant bacteria
:: managing the patient to stop any resistant bacteria spreading to others
:: robust infection prevention and control measures such as hand washing and comprehensive cleaning and decontamination
:: reviewing the employment of medical gadgets and prescribed antibiotics
Chief medical officer, Professor Dame Sally Davies, warned that the increase in antibiotic resistance is a “real threat to our ability to treat diseases”.
She said: “The new toolkit will ensure that hospitals are well placed to detect, manage and control any cases.”
Prof Davies added that resistant bacteria monitoring system are key to protecting the effect of antibiotics.
Enterobacteriaceae are normally harmless. But they can sometimes disperse away from the gut to regions such as the urinary tract or into the bloodstream, where they can cause serious infections.
This can happen through the use of medical devices such as urinary catheters or intravenous drips where the skin is punctured.
Source Nursing Times

Chip Identifies Bacterial Infection In Minutes, Not Days

Bacterial infections kill tens of thousands of North Americans every year. The fact it can take days to find out which bacteria are behind the infections and even longer to establish exactly which drugs will work, doesn’t help.

Now according to a new study, a chip that identifies bacteria in minutes promises to slash those timescales. And not only does the chip identify the specific pathogen, it can also tell which drugs it is resistant to, say researchers from the University of Toronto (U of T) in Canada.

Co-senior author Shana Kelley, of the department of Pharmacy and Biochemistry at U of T, and colleagues, write about their work in a 12 June online issue of Nature Communications.

Kelley says in a statement that drug-resistant bacteria are emerging all the time because antibiotics are either over-used or not used appropriately.

But this is not necessarily due to deliberate misuse or sloppy practice: a major factor can be the length of time it takes to find out exactly what is behind the infection and just as importantly, which drugs to treat it with.

It can be a race against time, and if time runs out, doctors have to make potentially life-saving decisions based on incomplete information.

What is missing is a “technology that rapidly offers physicians detailed information about the specific cause of the infection,” says Kelley.

Electronic devices that give a simple readout, based on highly sensitive and specific diagnostic tests that use small panels of biomarkers, already exist.

But what is needed is a device that can “interrogate samples for many dozens of biomarkers,” write the authors in their background information.

One of the barriers to developing such a device is how to design an inexpensive platform that can accommodate large arrays of electrode-based sensors.

With this challenge in mind, Kelley and colleagues set out to develop and test such a device.

They already knew the way to go was to use electronic chips, like the ones used for small panels of biomarkers, but somehow they needed to change the design so the chips could cope with what they describe as “highly multiplexed electrochemical sensing” in order to screen for many biomarkers at the same time.

And they found a way to do just this, using “solution-based circuits formed on chip”.

They designed and tested such a chip that could detect bacteria at concentrations found in patients with a urinary infection.

“The chip reported accurately on the type of bacteria in a sample, along with whether the pathogen possessed drug resistance,” say first author Brian Lam, a Chemistry PhD student at U of T.

The solution-based circuit concept allowed the chip to use the liquids in which the patient samples are immersed as a “switch”, so the team could look separately for each biomarker in turn, says co-senior author Ted Sargent, from the department of Electrical and Computer Engineering at U of T.

“The solution-based circuits switch the information-carrying signal readout channels and eliminate all measurable crosstalk from adjacent, biomolecule-specific microsensors,” note the authors.

“We also show that signature molecules can be accurately read 2 minutes after sample introduction,” they add.

Ihor Boszko, director of a Toronto-based business that develops in vitro diagnostics tools says the team’s new concept could have significant practical implications.

It will enable rapid screening for multiple viruses or bacteria that produce similar symptoms, and:

“It also allows for simple and cost effective manufacturing of highly multiplexed electrochemical detectors, which will certainly have a significant impact on the availability of effective diagnostic tools,” says Boszko.

The study is a good example of the kind of innovations that can occur when experts from different fields work together: in this case computer engineers, biologists, chemists, pharmacists, and more.

In another remarkable example of interdisciplinary teamwork, a study published early 2013 in the British Journal of Cancer describes how cancer researchers and astronomers put their heads together and adapted computerized stargazing techniques developed for spotting distant galaxies to identify biomarkers in tumors to determine how aggressive they are.

Source Medical News Today