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Rapid Antimicrobial susceptibility testing and phylogenetic Identification

Periodic Reporting for period 1 - RAPID (Rapid Antimicrobial susceptibility testing and phylogenetic Identification)

Reporting period: 2016-10-01 to 2018-03-31

A rapid, gene-based test has provided antimicrobial resistance profiles for one of the major multidrug resistant bacteria common in hospital infections.

Hospital-acquired infections caused by antibiotic-resistant opportunistic pathogens are on the increase world-wide and pose one of the greatest challenges to modern medicine. Multi-drug resistance dramatically impacts on human health, public health and the principles and practice of clinical medicine. Management of nosocomial infections, especially those caused by multidrug-resistant gram-negative bacteria, requires a multipronged strategy that includes not only the development of new antimicrobial compounds and a rational use of antimicrobial agents, but also early diagnosis for targeted antibiotic treatment and the implementation of effective infection control principles. However, In spite of the initial enthusiasm and the massive literature from research, gene-detection based molecular methods have not yet had the impact on routine diagnostic microbiology that many had predicted. In the EU-funded project RAPID we have developed a cost-effective assay that could change the current model of culture-based microbial diagnostics and provide the surveillance necessary for detecting multi-drug resistance.
The RAPID test is a gene-detection-based high-density molecular system which screens for more than 50 genetic resistance determinants in the Klebsiella pneumoniae (K. pneumoniae) genome as well as for phylogeny informative sequence variations. The assay enables timely and more detailed information on antimicrobial resistance profiles for more effective antibiotic treatment, and facilitates tracking of bacterial pathogen spread in the hospital setting. With the design of the assay now completed, more than 800 clinical K. pneumoniae isolates have passed through the RAPID screens. The sheer number of tests has validated its sensitivity and specificity to detect resistance.
Cost is affordable at EUR 10 for materials. However, the real savings come with targeted, more effective therapies and possibly shorter stays in hospital. Furthermore, the reduction of spread from patient to patient may well be of highest value in the hospital ward.