19/07/22 - A new method that can both detect the presence of a bacterial infection and determine which antibiotics will be most effective for treatment in less than 5 hours, instead of days, was today published in the international medical journal The Lancet eBiomedicine.
· Each year 1.27 million people worldwide die from infections resistant to antibiotics
· Current tests take 2-5 days to isolate infecting bacteria and identify effective antibiotic
· In serious infection, every hour without effective antibiotics increases risk of death by 6.7%
Bacterial infections are a major cause of death in children and adults worldwide. Without effective antibiotics, patients deteriorate rapidly and can die within hours. However, the standard process to identify the bacteria causing an infection and match them with the best antibiotic treatment can take days.
A research team from the Harry Perkins Institute of Medical Research, The University of Western Australia and PathWest Laboratory Medicine WA including Perth renal physician, Dr Aron Chakera and UWA Forrest Prospect Fellow, Dr Kieran Mulroney, have developed a faster, more effective process to confirm infections and find the most effective treatment for them.
“The established method involves growing bacteria from a patient sample then applying different antibiotics to see which are effective. Patients with serious infections cannot wait the several days it can take to return antibiotic test results. Consequently, the patient's doctor has to rely on a best guess, 'one-size-fits-all', antibiotic choice to treat patients.
“The biggest problem with prescribing broad-spectrum antibiotics is that it encourages some bacteria to become resistant to the antibiotics. This is a growing and serious problem world-wide, because antibiotic resistant bacteria can spread from person to person and reduce treatment options.
“The overuse of broad-spectrum antibiotics is one of the key drivers in the spread of resistance to antibiotics,” Dr Mulroney said.
Quicker, more accurate, tests mean treatment can be targeted to each infection, so the antibiotics are just right – not too strong, and not ineffective.
“New tests are urgently needed that give doctors evidence they can rely on to select the right antibiotic” he said.
Dr Mulroney said the team has developed a two-step process:
“First, we developed a test to confirm if the cause of the patient’s serious illness is a bacterial infection. This test takes 30 minutes, rather than 1-2 days.
“Once a patient has a confirmed bacterial infection, we then expose the bacteria to different types of antibiotics in the laboratory. Using a device that measures hundreds of thousands of individual bacteria in just a few seconds, the research team can detect the damage antibiotics cause to bacteria, and then use this information to confirm which antibiotic will be an effective treatment. We can predict which antibiotics will be effective to treat that infection with 96.9% accuracy,” Dr Mulroney said.
Sir Charles Gairdner Hospital renal physician Dr Chakera says for patients with chronic illnesses the discovery will be potentially life-saving.
“As a renal physician I treat patients with end-stage kidney disease who need to be in hospitals or clinics for several hours a week connected to dialysis machines. Many could manage their own dialysis using a surgically implanted catheter, which actually has better outcomes, is far less costly and is more satisfying for patients, but the ever-present fear of infection from the catheter deters many from choosing it.
“This new test would give confidence to patients and their treating doctors,” Dr Chakera said.
WA Country Health Service Translation Fellow, Dr Tim Inglis has seen the method develop from its earliest test tube observations into a robust clinical laboratory method with a broad range of applications.
“The time and effort it takes to produce accurate antibiotic test results make this technique very attractive to busy clinical laboratories. The last two years has shown us how important test results are in the battle against infection. When the COVID pandemic finally tails off, the challenge of antibiotic resistance will still be there, demanding urgent attention from the clinical lab."
“Even in the most advanced health systems, hospital patients risk bacterial infection through trauma wounds, surgery sites, breathing machines and indwelling catheters. This can lead to pneumonia, urinary tract, abdominal and bloodstream infections. Applying the research team's new technology to these infections is expected to transform how quickly and effectively we treat patients in Western Australia and further afield,” Dr Inglis said.
Link to the publication: “Same-day confirmation of infection and antimicrobial susceptibility profiling using flow cytometry.” https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00326-7/fulltext.
About the research team
Drs Mulroney, Chakera and Inglis have grants for this work from the Australian National Health and Medical Research Council, the Health Department of Western Australia's Future Health Research & Innovation (FHRI) Fund, and Western Australian philanthropists. Dr Mulroney is a Forrest Foundation Prospect Fellow for outstanding early-career research which has enabled him to undertake this innovative work in Western Australia. Dr Inglis is FHRI Translation Fellow with the Western Australian Country Health Service.
Dr Kieran Mulroney Dr Aron Chakera
Media Contacts: Miriam Borthwick M 0437 411 683 E email@example.com
About the Harry Perkins Institute of Medical Research www.perkins.org.au
The Harry Perkins Institute of Medical Research is WA’s largest medical research institute that primarily investigates diseases affecting adults. With over 250 researchers located on three hospital campuses, the Perkins is uniquely positioned to fast track the development of new discoveries and treatments. By collaborating with doctors, world-class researchers, scientists and clinicians, the Perkins takes discoveries from the laboratory bench top to the bedside. The Harry Perkins Institute of Medical Research is proudly West Australian, providing career opportunities to our best and brightest graduates and bringing to the State world-class researchers. As a registered charity, the Harry Perkins Institute relies on grants and donations to fund its medical research.