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Innovations in point of care testing for bacterial infections: The Longitude Prize with Daniel Berman
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Innovations in point of care testing for bacterial infections: The Longitude Prize with Daniel Berman
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2020-04-28T00:00:00.0000000
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Language: EN.
Segment:1 Innovations in point of care testing for bacterial infections: The Longitude Prize with Daniel Berman .
[MUSIC PLAYING]
Segment:2 Please could you introduce yourself?.
DANIEL BERMAN: I'm Daniel Berman. And I'm the Head of Global Health at Nesta Challenges.
Segment:3 What is the Longitude Prize and why was innovative rapid diagnostic tests for bacterial infections chosen for the prize?.
DANIEL BERMAN: I think the place to start is to talk about really the challenge of AMR. And I think it's quite important to say from the onset that antimicrobial resistance is something that actually needs to be approached by all angles. So for example, putting antibiotics into animal feed needs to stop.
DANIEL BERMAN: And sanitation is important. But the one part of it that the Longitude Prize is focusing on is rapid diagnostic tests. And basically, there's two things that rapid tests can do. They can eliminate unnecessary use of antibiotics and also choose the right antibiotic for each patient-- so one that will work, that's not resistant, and one that is fit for purpose for a particular pathogen.
DANIEL BERMAN: And in terms of the Longitude Prize, what it is, and how it works, basically it's a challenge prize or an inducement prize. And what prizes do is they focus people on a very precise objective-- in this case, developing a rapid test that will be fast, accurate, affordable, and point of care. And when I say "point of care," what I mean is that it shouldn't be a test that needs to be done in a laboratory but that it can be done by a physician, by a nurse, by a pharmacist, or even the person themselves.
DANIEL BERMAN: And to make it very concrete, what I'm referring to-- if you go to, for example, GP surgery, and you have a fever and symptoms-- let's say a stuffy nose-- how do you know whether it's viral or bacterial? And 70% of adults which are presenting with those symptoms actually don't need antibiotics. So a rapid diagnostic test would identify whether you need antibiotics or not and which one to use.
DANIEL BERMAN:
Segment:4 What impact would such tests have on the battle against antibiotic resistance?.
DANIEL BERMAN: A diagnostic test basically helps steer the use of antibiotics. And when we talk about impact, I think it's important to keep in mind that the latest data that just came out a few weeks ago from the US showed that every 15 minutes, someone is dying of a resistant infection.
DANIEL BERMAN: So this is really a critical global problem. And what the tests would do is it would-- instead of somebody taking an antibiotic that maybe doesn't work for them because the pathogen is resistant to that antibiotic, it would help identify that antibiotic that works. And I think even if you take the UK, some people in the physician community have said, well, urinary tract infections-- we get it right about 70% of the time.
DANIEL BERMAN: So we use the syndromic approach. We look at symptoms. And then we immediately prescribe an antibiotic in every case. And on the one hand, 70% sounds like it's a good number. But E. coli is the pathogen in the vast majority of cases. And E. coli is a very dangerous pathogen. So if we're not getting it right for urinary tract infections, if patients in hospital get E. coli, there's more chance that the E. coli is resistant.
DANIEL BERMAN: So what I'm saying is that these things are interrelated. And so what a diagnostic test would do in that situation is it would immediately in real time say whether the patient actually had a urinary tract infection and then look at a battery of antibiotics and be able to indicate which antibiotic would work. Today it takes 48 hours to get that information through culture. So it's just not practical because for the patient's good, it is right practice today because there is no test to give the antibiotic without having information.
DANIEL BERMAN: But we're kind of in the dark in terms of how we're using antibiotics. And so a diagnostic test will allow us to be more precise, which will have a dramatic impact on slowing resistance so that antibiotics will continue to work.
Segment:5 Can you tell us more about any of the innovations currently in the running for the Longitude Prize?.
DANIEL BERMAN: The Longitude Prize actually has stimulated people to come into the competition who wouldn't ordinarily have been working on a rapid diagnostic test.
DANIEL BERMAN: And that's one of the beauties of a Challenge prize. And there are some really cutting-edge technologies that are being used. So there is a company in the UK called Mologic. They're very well known because they invented the home test for pregnancy. And they are using cutting-edge technology which will diagnose and predict sepsis. So sepsis, of course, is severe blood infection that is life threatening.
DANIEL BERMAN: So what their test does is it uses five biomarkers in the blood. And basically, very quickly, by taking a blood sample you can get an answer using an algorithm of whether the patient has sepsis or not. And so that's really one that will definitely save lives. Other technologies are microfluidics.
DANIEL BERMAN: Now, microfluidics have been around a long time. And to explain it simply, it can be used on the size of a credit card. And on the credit card, it almost looks like a map. And the test is actually done on a very small space, which means you use very little reagents. And so it's affordable. And actually, it's almost like a commodity. The tests would be printed like circuit boards, and so they would be very affordable.
DANIEL BERMAN: And that one is for urinary tract infections. And other technologies that we have are basically taking photos or videos and comparing them against a database. So one of them is for strep, strep throat, because that's a case where it's really hard to know whether it's a viral or a bacterial infection. And so by taking this photo, within a few minutes you have a result. And you know exactly whether it's a bacterial infection or not.
Segment:6 Are there any innovations that stand out?.
DANIEL BERMAN: As you can imagine, since we're trying to be objective, it's difficult. But let me mention a couple. So one is a company called Lumos. It's based in the US. And basically, their test looks at whether an infection is viral or bacterial. But it's a very cool test. It's similar to the HIV test in the sense that it's very easy to use.
DANIEL BERMAN: It's not designed to be used in a lab. And the whole test is a single-use test. And it works by giving a finger prick-- and so just a drop of blood. And the device collects that drop. And within 20 minutes, you know whether it's viral or bacterial infection. So within the NHS, we don't envision that this type of test would be used for all patients because that would be too expensive.
DANIEL BERMAN: But the Longitude Prize and Nesta is working very closely with NHS. And we're looking at getting these tests once they come to market being actually piloted in NHS right away. So a test like that would be very useful. Another one is company in Sweden called Astrego. and Astrego is using microfluidics for urinary tract infections to see whether antibiotics are susceptible or not.
DANIEL BERMAN: And so that is a case where, instead of today, just arbitrarily giving antibiotics to the huge number of mostly women who present at GP surgeries, imagine if that test pans out. And we can, within a few minutes, tell people which antibiotic will work rather than randomly-- because today, for urinary tract infections, every woman is given the same first-line antibiotic. And it's not really good medicine.
