Point-of-care Diagnostic Test for UTIs to Help Tackle Antimicrobial Resistance

Antimicrobial resistance (AMR) is a growing concern to public health, threatening to make surgery, chemotherapy, and treatment to many infections no longer viable. While the development of new antibiotics remains important, working towards more appropriate use of current treatments is perhaps more critical. In order to achieve this, clinicians need access to rapid and effective tools to help guide their treatment decisions and stop misuse of antibiotics.

We spoke to Barbara Fallowfield, Commercial Manager, Mologic, to learn how improvements in diagnostics could help clinicians to overcome current antimicrobial stewardship challenges and better tackle antimicrobial resistance.

Anna MacDonald (AM): What obstacles do clinicians currently face in trying to tackle this issue? 

Barbara Fallowfield (BF): In primary care, where the majority of antibiotic prescriptions are written, a lack of rapid diagnostic tools is a particular obstacle. Physicians report feeling under pressure to write a prescription, but don’t have tools available to guide their decisions. The type of test required at point of care could be either a simple one which says whether the patient has a bacterial infection or not ie would antibiotics be helpful, or could provide further information about which antibiotic would be effective if a bacterial infection is present.

AM: Fraunhofer and Mologic have recently partnered to produce a point-of-care diagnosis and antibiotic susceptibility test for UTIs. Can you tell us more about this technology and how the partnership came about?

BF: The test is based on the concept of combining silicon photonic waveguides and microfluidics to get very precise and rapid results. The overall device/reader/instrument will be designed by WideBlue based on Fraunhofer's lab prototype to be suitable for clinical trial.  The chip/single-use component/disposable part  is a combination of silicon photonics for the optical interrogation combined with a polymeric microfluidic structure. The urine sample flows through the microfluidic, and the proprietary mechanism is interrogated by the light passing through the silicon photonic part. Fraunhofer UK is a not-for-profit organisation, and were looking for a company experienced in the development, manufacture and commercialisation of IVD point-of-care products to work with – Mologic fits that profile.

AM: What role can tests such as this play in tackling antimicrobial resistance?

BF: Tests such as this one help tackle AMR by enabling physicians to make informed decisions not only whether antibiotics are prescribed, but which ones will be effective, all at the time a patient is in front of them. This helps to reduce the number of antibiotic prescriptions which may be written when they are not required, ie when the patient symptoms are not due to bacterial infection. Providing information about which antibiotic will be effective helps with antibiotic stewardship, as it avoids the potential to prescribe more powerful antibiotics ‘just in case’ the routine ones won’t work.

AM: What trends are you seeing in the IVD market?

BF: There is an increasing awareness of the usefulness of IVDs in helping tackle AMR. Whereas previously all the focus was on pharmaceutical companies to develop new antibiotics, there is now recognition that if prescribing patterns don’t change then even new antibiotics will have a very limited lifespan. IVDs can be very useful in guiding whether antibiotics are required, and which ones will work. There is also increasing recognition of the role of IVDs in helping patients with long term or chronic diseases to manage their conditions at home – this has benefits to the overall health system by reducing the number of healthcare professional/patient interactions required, and also empowers the patient as they feel they have a better understanding and therefore more control of their condition. The use of IVDs in a primary care setting has potential to save healthcare system money through rapid, accurate diagnosis and therefore appropriate treatment at the time the patient presents, eg Group A Strep infection in a throat swab, urinary tract infection, Strep pneumoniae or Legionella infection from a urine sample, however funding routes are often a disincentive to their use in this way. The trend for personalised medicine is often leading to a requirement for a matching ‘personalised diagnostic’ – often called ‘companion diagnostics’, but in fact the term ‘diagnostic dependent drug’ could equally be used to describe the therapeutic.

Barbara Fallowfield was speaking to Anna MacDonald, Science Writer for Technology Networks.