'New bug detector could save lives'

11/12/2014

By Niall Hunter

Manufacturers of new medical technology say it can potentially save patients lives by identifying more rapidly exactly which bacteria are causing serious infections.

Currently, slow turnaround time for test results often means that doctors have to guess what type of bacteria, virus or fungus might be causing a particular infection and therefore how to treat it.

In serious cases of bacterial infection, this can sometimes lead to patients being given the wrong antibiotic which does not deal with the infection and therefore can lead to the patient becoming more ill or even dying of sepsis.

And combating sepsis is a growing issue for health systems worldwide

In Ireland, while hospital statistics do not capture underlying cause of death, in 2013, up to 60% of all hospital deaths had a sepsis or infection diagnosis with approximately 16% of all hospital deaths designated with an officially confirmed sepsis-specific diagnosis code.

The total number of cases in Ireland with a diagnosis of sepsis was 8,831 in 2013 and these cases accounted for a total of 221,342 bed days with an estimated cost of €125 million.

Sepsis essentially means where the body eventually shuts down and ceases to function if a serious infection is allowed to develop to a critical stage.

The new equipment is a diagnostic platform which uses mass spectrometry to check genetic material in specimens sent to hospital laboratories for analysis.

Recent research on this technology has indicated that it can produce test results in around six hours, compared to an average of 48 hours using current methods.

Reducing this crucial time-gap could potentially save lives in cases of serious infection, experts believe.

The first available model of the new equipment, known as IRIDICA, was launched in Europe this week by the medical diagnostics company Abbott.

At the launch conference in Paris, medical experts highlighted how current laboratory infection testing processes in hospitals can be slow and cumbersome, involving the growing of cultures from specimens, a method that dates back 100 years.

Sometimes the test results can take a number of days to come back, by which time a seriously ill patient might have deteriorated or even died.

This issue was highlighted at the conference by Dr David Brealey, an intensive care specialist at University College Hospital London.

He said using current testing systems, despite doctors doing everything they can, patients with serious infections can get sicker and ultimately even die from sepsis.

He gave the example of one of his patients, a young nurse, who died from sepsis but who may have been saved if the hospital had been able to detect more quickly what the cause of her underlying infection was.

Dr Brealey said the day after the patient died, the lab phoned with the test result, which revealed she had had a serious bacteria known as Klebsiella. He said the antibiotic the hospital had been using on the patient 'would not have touched' this particular bug.

However, if the hospital had known more quickly the pathogen involved, a more specific antibiotic could have been prescribed and the patient's life might have been saved.

Dr Brealey stressed the importance of using better diagnostic tools to combat sepsis, which currently kills one in five patients who get it and, in terms of frequency, 'can make cancer look like a rare disease'.

He said worldwide, the condition currently kills more mothers than blood clots.

They felt the new testing method could also save health systems millions of euro in costly intensive care treatment for very sick patients.

The conference was also told the current slower diagnostic testing methods have led to the over-use of broad spectrum antibiotics, which are indicated for a wide range of infections.

Often, as doctors cannot wait for test results to come back, they tend to employ this ‘blunderbuss approach' when prescribing antibiotics as they don't know at that stage which drugs would be best to fight the infection.

Knowing exactly what type of infection they are dealing with at an early stage would mean that doctors could target specific antibiotics for specific infections.

It was pointed out at the conference that over-use of broad spectrum antibiotics is contributing to the worldwide growth of antibiotic resistance, where antibiotics are becoming less effective against common infections.

CEO of the Irish Patients Association Stephen McMahon told the Paris launch that there was an urgent need for health systems to deal with the problem of sepsis.

He said millions of deaths worldwide are taking place each year linked to sepsis and healthcare-associated infections (HCAIs).

HCAIs occur when infections take place as a result of treatment - many of these infections can be resistant to commonly-prescribed antibiotics.

Abbott says the IRIDICA equipment costs in the region of €700,000 and it is now available for hospitals throughout Europe. The company said while there has been interest from Ireland in the new equipment, there is no indication at this time of specific hospitals which may be interested in purchasing it.

It is already in use at the Hopital St Louis in Paris, where doctors say it has speeded up considerably the time it takes to detect pathogens causing infections.

The launch conference stressed that the new equipment would enable more targeted and effective use of existing antibiotics.

However, it is accepted that newer types of antibiotics need to be developed to combat the growing trend of antibiotic resistance.

 


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