Health econometrics study to inform the Detection & Identification of Infectious Agents (DIIA), Innovation Platform. [FUNDERS: Technology Strategy Board & Department of Health].

PROJECT FUNDING: Technology Strategy Board & Department of Health (£149,534)
Rapid diagnosticsThere is a clear opportunity for developing rapid diagnostic tests, including point of care (POC) devices, for the detection and identification of infectious diseases. A range of diseases were prioritised by government (DH and DEFRA). The DH has identified TB, sepsis, antimicrobial resistance and STIs as high priority areas.1. Tuberculosis (TB): Only about 10% of people infected with TB will develop TB disease at some time in their lifetime as bacteria that cause TB can survive in the body for many years in an inactive state without causing disease (latent TB). The issue of latent infection, particularly among non-UK born people, remains the biggest unaddressed source of disease. A test which demonstrates the presence of infection and was highly predictive for the development of active disease, would allow chemoprophylaxis for those predicted to go on to develop disease. A rapid test is also needed to demonstrate active TB as currently the ‘gold standard’ test requires culturing of bacteria from sputum samples that can take up to 12 weeks. Drug resistant TB remains a problem, particularly in London and early indication of drug resistance would enable clinicians to tailor drug therapy more accurately, and help prevent development of drug resistant strains through inappropriate drug therapy.2. Sepsis: Mortality from sepsis is 30 to 50% but treatment of severe sepsis in the first 6 hours after diagnosis has been shown to have a dramatic effect on survival. A rapid, safe and reliable way of identifying adults and children at risk of, or suffering from, early sepsis in primary care and hospital settings would allow therapy to be commenced at an early stage, significantly reducing patient mortality and morbidity.3. Antimicrobial resistance: Antimicrobial-resistant infections increase the risk of death for hospital patients by a factor of 1.9 to 5. In many cases, the initial choice of antimicrobial treatment, has to be made empirically without knowledge of the particular pathogen involved. This has resulted in the over-prescription of broad spectrum agents. Improved targeting of therapies could be achieved if rapid identification of the pathogens could be obtained prior to a decision on therapy being taken. Of particular priority to the DH are antimicrobial resistance tests in the following areas:oHospital-acquired infections (HAIs)Methicillin-Resistant Staphylococcus aureus (MRSA)Clostridium difficileoCommunity-acquired pneumonia (CAP)oAntibiotic prescribing in Primary Care4. Sexually Transmitted Infections (STIs: )Currently most tests for gonorrhoea and chlamydia are expensive and/or technically complex and require the support of a laboratory. Results are not usually available before the patient has left the clinic and this delay can lead to patients not returning for treatment and may allow further STI transmission to occur. There is a need for a simple, rapid, cost effective test for STIs that can be used at the POC.