Rapid Microbial Detection: Current and future trends in healthcare Surbhi MALHOTRA-KUMAR Senior Research Associate PhD (Med Microb ) MSc (Med Microb ) MSc (Mol PhD (Med. Microb.), MSc (Med. Microb.), MSc (Mol. Biol. & Biotech.) Department of Medical Microbiology Vaccine & Infectious Disease Institute Vaccine & Infectious Disease Institute Universiteit Antwerpen, Belgium
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Rapid Microbial Detection: Current and future trends in ... · Rapid Microbial Detection: Current and future trends in healthcare Surbhi MALHOTRA-KUMAR Senior Research Associate PhD
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Rapid Microbial Detection: Current and future trends in healthcare
Integrated point of care test/personalized medicine
µPCR Photonic sensorsensor
Why Require Better, Rapid Point-of-CareAssays?
• There has been under-investment in rapid diagnostics for improving the quality of care for patients withfor improving the quality of care for patients with suspected infections– Diagnostics influence 60-70% of health care decision making but
account for less than 5% of hospital costs (Lewin report 2006)account for less than 5% of hospital costs (Lewin report 2006)
POCT i tibi ti t ti t l th h• POCTs improve antibiotic targeting to only those who will benefit, thus reducing overuse– The commonest reason for prescribing antibiotics in the p g
community is acute cough, and these prescriptions virtually never benefit patients (Butler et al, BMJ 2009)
Why Require Better, Rapid Point-of-CareAssays?
• POCTs enhance surveillance of pathogens and infectious diseasesinfectious diseases– e.g. H1N1 flu pandemic
• POCTs support rapid initiation and cessation of treatment
Sepsis is associated with 7% increased mortality for every hour– Sepsis is associated with 7% increased mortality for every hour delay in the administration of appropriate antibiotics (Kumar et al, CCM 2006)
• POCTs decrease the size and cost of antibacterial clinical trialsclinical trials– We URGENTLY need new antibiotics (ECDC/EMA report 2009)
Why Has It Not Happened Till Now?
Can you imagine the challenges of shrinkingchallenges of shrinking a huge laboratory filled with people and equipment onto a singleequipment onto a single chip the size of a matchbox?
Huge Challenges and Synergies
BiotechnologiesIntegrated sample prep solutions Bi l i l
Clinical practiceSelection of relevantIntegrated sample prep solutions
Targeting NA + host/pathogen biomarkers
N l f h i t i
Biological Sciences
Selection of relevant targets/applications
Validation of analytical, clinical performanceNovel surface chemistries clinical performance
Physical Sciences
Clinical Practice
(Micro)technologiesLab-on-a-chip/microfluidics
PhotonicsPhotonics
Biosensors
A Big Bottleneck in Developing POCTs: Sample Preparation
R i t if b d b t– Requires centrifuges, bead beaters, several machines
– Few hours
• On-chip sample prep• Room temperature stable reagents
(di bl hi ith hi(disposable chips with on-chip storage)
• Microliter volumes
• Few minutes!!
On-chip Bacterial Lysis and DNA Purification
Development of a proprietary bacterial lysis and DNApurification protocol and its successful application on apurification protocol and its successful application on aprototypal microfluidic chip for a CA-LRTI assay
In collaboration with Institut für Mikrotechnik, Mainz, Germany
Van Heirstraeten et al., ECCMID, 2011
On-chip Bacterial Lysis, DNA Purification/Amplification
Development of a sample prep solution and on-chip micro-PCR for a rapid patient bed-side sepsis assayPCR for a rapid patient bed side sepsis assay
In collaboration with KTH Royal Institute for Technology, Stockholm, Sweden
Developing an efficient, rapid and accurate POCT
• The joint efforts of academia and industry can bring this to realityy
• IMI supports collaborative research projects and builds networks of industrial and academic experts in order to boost pharmaceutical innovation in Europe
Microfluidic ChipShop GmbH, Germany
Primary care Hospital care
RAPP-ID Project Phases
EFPIA MEMBER COMPANIES
- GlaxoSmithKline
UNIVERSITIES, RESEARCH ORGANISATIONS, PUBLIC BODIES &
NON-PROFIT- Cardiff University, UK- Catholic University of Leuven, Belgium- IMEC, Belgium
U i it f C b id UK
- LIONEX, Germany- Microfluidic ChipShop, Germany- Mobidiag, Finland
- Sanofi-Aventis - University of Cambridge, UK- Geneva University, Switzerland- Ghent University, Belgium- Royal Institute of Technology, Sweden
- Q-linea, Sweden
oya s u e o ec o ogy, S ede- University of Antwerp, Belgium- University of Twente, Netherlands- Uppsala University, Sweden
C ll bCollaborators
Overall Objective of RAPP-ID
RAPP-ID will develop a Point-of-Care Test (POCT) for rapid (hospital <2h primary care(hospital <2h, primary care <30min) detection of bacteria, mycobacteria, fungi, as well as viruses and host biomarkers by combining novel specific probes, novel methods of sample preparation, and demonstrated ultra-high sensitive detectionultra high sensitive detection methods. The platforms will also determine resistance to antimicrobial drugs
• IMI is a unique instrument of joint academia-industry initiatives, and this is the ONLY way to successfullyinitiatives, and this is the ONLY way to successfully develop POCT for Infectious Diseases
• RAPP-ID partners have built up experience in other EU p p pfunded projects (GRACE, InTopSens, TheraEDGE, ...)
• RAPP-ID provides a unique combination of a whole range of novel assays and technologies
• POCT development will not only be “pathogen or t h l i ll d i ’ b t l d i d t t l ltechnologically driven’ but also designed to meet clearly defined clinical needs with optimal integration and implementation into diagnostic/clinical algorithms and p g ghealthcare programs