Antibiotic resistance: rapid test helps to deliver the "right" drug
The increase in resistance to antibiotics presents the healthcare system with an ever increasing challenge. If such medications stop working, even small inflammations can become a big risk. German researchers have now developed a new type of rapid test that quickly provides information about which antibiotic is still effective in a specific case.
Dangerous increase in antibiotic resistance
Multi-resistant germs are a growing threat. The massive and often unnecessary use of antibiotics means that more and more pathogens are insensitive to medication. It was only last year that an EU Commission warned of massively increasing antibiotic resistance. If the problem is not brought under control soon, researchers face a horror scenario. According to an older study by the Berlin Charité, there could be around ten million deaths from multi-resistant germs by 2050. Infections that have been treatable so far can be life-threatening. A new test could help to reduce the spread of resistance in the future.
Faster diagnostics save lives
As the Leibniz Institute for Photonic Technologies (Leibniz-IPHT) writes in a current release, a new type of rapid test can provide information within three and a half hours about which antibiotic is still effective in a specific case.
Faster diagnostics enable personalized therapy and save lives.
According to the experts, the targeted, economical and responsible use of (broad-spectrum and reserve) antibiotics is a prerequisite to curb the spread of resistance.
With standard procedures it sometimes takes three days to get the result
Scientists from the Leibniz Institute for Photonic Technologies (Leibniz-IPHT), the Center for Sepsis Control and Care of the Jena University Hospital and the Friedrich Schiller University Jena are working on a fast, inexpensive alternative to the previously time-consuming microbiological pathogen diagnostics.
“We combine light-based analysis methods with microfluidic sample processing. With our lab-on-a-chip system, ie a miniaturized laboratory, we can clearly determine bacterial strains and their resistance in less than three and a half hours, ”project manager Prof. Ute Neugebauer explains the advantage of the new approach.
Standard procedures for infection diagnosis sometimes take 72 hours to produce a reliable result.
One of the reasons for this is that the number of pathogens in a patient sample is far too small to be able to carry out tests. An analysis is only possible after a time-consuming cultivation.
Doctors often have to “blindly” treat with antibiotics
Especially in clinical use, in the treatment of serious infections, e.g. in sepsis, time is a critical factor.
Intensive care physicians face a worrying dilemma: "Too often we have to treat 'blind' with broad-spectrum antibiotics, because we can initially neither determine the pathogen nor any existing resistance," said Prof. Michael Bauer, director of the Clinic for Anaesthesiology and Intensive Care Medicine at the University Hospital Jena .
“So we may shoot cannons at sparrows. A vicious circle that favors the emergence of new resistances. "
Basis for a reliable therapy decision
The new method from Jena provides a significantly faster diagnosis as the basis for a reliable therapy decision.
Ute Neugebauer, who works at Leibniz-IPHT and at the University Hospital in Jena, points to tiny electrodes that are attached to the surface of the chip, which is about the size of a postage stamp: "Here, electric fields fix the bacteria in a very small area."
Trapped there, the Jena researchers bring the pathogens into contact with various antibiotics in different concentrations and examine them with the help of Raman spectroscopy.
"That means we irradiate the pathogens with laser light and evaluate the scattered light spectrum," Neugebauer describes the method.
“After just two hours, we see clear changes in the Raman spectra. From this it can be deduced whether the strain is resistant or sensitive, ”explains Prof. Jürgen Popp, director of Leibniz-IPHT and head of the Institute for Physical Chemistry at Friedrich-Schiller-University Jena.
“At the same time, we receive information about how high the concentration of the antibiotic must be in order to completely inhibit bacterial growth. This is an important diagnostic parameter that has a decisive influence on the success of the treatment, ”continues Popp.
The team of chemists, doctors and biologists presented the results in the journal "Analytical Chemistry".
Help with the right medication
The combination of fast, light-based diagnostics and a high degree of automation reduces the time from sampling to the result from 72 to three and a half hours.
"Such a fast procedure could revolutionize the diagnosis of infectious diseases," says Prof. Bettina Löffler, director of the Institute for Medical Microbiology at the University Hospital Jena.
The researchers are currently working on a platform for use in hospitals.
Another goal going further into the future is the further development of a cartridge-based rapid test system, which for the first time will enable general practitioners to determine resistance quickly and easily.
This would give doctors a powerful tool that they can use to make personalized therapy decisions, i.e. supported in the allocation of the appropriate medication. (ad)