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An Integrated Tool-Kit for the Clinical Evaluation of Microbial Detection and Antibiotic Susceptibility Point-of-Care Testing Technologies

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Point-of-care microbiological detection

Incorporation of newly developed technologies in the field of medical microbiology has the potential to revolutionise diagnostics at the point-of-care (POC). This is expected to speed up pathogen detection and better identify cases of antibiotic resistance.

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The emergence of antibiotic-resistant bacteria is an increasing problem with serious health implications. The lack of novel antibiotics to treat resistant bacteria indicates that alternative measures need to be taken. Experts recommend that we should be cautious of high-volume antibiotic consumption and emphasise the importance of POC assays for detecting resistant pathogens. Based on this recommendation, the EU-funded TEMPOTEST-QC project was established to help businesses and developers of state-of-the-art technologies to evaluate and accelerate the implementation of novel POC tools for pathogen diagnosis. The study addressed various hurdles associated with POC diagnostics, including test sensitivity and ease of use. Firstly, an online questionnaire was established to determine the current perceived hurdles to the introduction of infectious disease POC testing. The results (showed that the general public is enthusiastic towards POC testing, but that clinicians tend to be less passionate about the implementation of such POC devices. Consortium partners also collected a standardised archive of over 2 000 bacterial pathogens as a reference set of bacterial isolates for quality control purposes. An additional archive of nearly 1 000 clinical specimens was also collected. Both archives were used for the evaluation of new infectious disease diagnostics tools in the TEMPOTEST-QC project. During the time period of the project, the consortium focussed its attention on evaluating many state-of-the art techniques, including the evaluation and development of 'electronic nose' technology that could be utilized for microbiological detection. Further, a large microarray platform able to detect an exhaustive range of antibiotic genes was also evaluated. A considerable part of the project's work was focused on the detection of carbapenem-resistance genes and enzymes using a range of techniques that varied from simple spectrophotometry to microarray and polymerase chain reaction experiements. Given that carbapenems constitute the last line of defence against antibiotic-resistant organisms, the rapid detection of this type of resistant bacteria is crucial in monitoring and preventing the spread of this class of antibiotic resistance. Overall, the TEMPOTEST-QC project aimed to help businesses and developers evaluate and implement their novel technologies towards a marketable POC tool for pathogen detection, with special emphasis on the detection of antibiotic resistance. Such devices will offer a significant improvement with respect to the sensitivity and speed of diagnosis compared to the current, traditional, techniques currently used in routine infectious disease diagnostic laboratories.

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