Rapid detection of multi-drug-resistant bacteria
Emerging resistance to antimicrobials continues to whittle away the treatment options for opportunistic infections in patients undergoing treatment for other conditions. Equipment such as ventilators and catheters encourage invasion of these pathogens and patients continue to be at risk. In spite of the initial enthusiasm and the massive literature from research, gene-detection based molecular methods have not yet had the impact on routine diagnostic microbiology that many had predicted. “To change this situation, clinical microbiology needs to provide more impact on the management of infectious diseases and should accommodate the general drive towards more cost-efficient medicine,” outlines Prof. Susanne Häussler, RAPID project coordinator. The EU-funded project RAPID has developed a cost-effective assay that could change the current model of culture-based microbial diagnostics and provide the surveillance necessary for detecting multi-drug resistance. Rapid, robust and reasonably priced resistance profiles Currently, results from samples arriving in the lab are available after two full days. RAPID diagnostics however are ready after only one full day of testing, a significant improvement when appropriate antimicrobials could be administered to clear any infection. Reduction of the stay in hospitalisation and a hike in improvement in prognosis are just two massive benefits for patients and healthcare authorities. Screening for 58 of the genetic resistance determinants in the Klebsiella pneumoniae (K. pneumoniae) genome as well as for phylogeny informative sequence variations, the RAPID test is a gene-detection-based high-density molecular system. The test gives valuable information on the evolutionary relationships between the groups of microbes. “This enables timely and more detailed information on antimicrobial resistance profiles for more effective antibiotic treatment and facilitates tracking of bacterial pathogen spread in the hospital setting,” explains Prof. Häussler. With the design of the assay now completed, more than 800 clinical K. pneumoniae isolates have passed through the RAPID screens. The sheer number of tests has validated its sensitivity and specificity to detect resistance. Cost is affordable at EUR 10 for materials, slightly higher than the conventional cost of up to EUR 7. However, the real savings come with targeted, more effective therapies and possibly shorter stays in hospital. “Reduction of spread from patient to patient may well be of highest value in the hospital ward,” points out Prof. Häussler. Road from the lab to the clinic RAPID has designed a robust molecular resistance detection assay with excellent technical performance when used with clinical K. pneumoniae isolates. “An important pre-requisite for commercialisation, the next step will be to demonstrate that its broad use in the clinic will indeed improve management of multi-drug resistant bacteria and thus improve patient care,” Prof. Häussler concludes. Implementation of RAPID, a tailored and cost-effective diagnostic tool, in clinical microbiology laboratories could provide critical information for decision-making with respect to prudent antibiotic use. The test tackles multi-drug resistant opportunistic pathogens, which until now have remained underfunded.
Keywords
RAPID, resistance, hospital, antimicrobial, bacteria