Rapid UTI test that reduces detection time to 45 minutes, awarded the Longitude Prize
An £8 million prize for a breakthrough in the fight against superbugs has been awarded to a test that can identify how to treat a urinary tract infection in 45 minutes, after a ten-year search for a winner.
The test could herald a “major change” in antibiotic use, the judges said as they announced the winner of the Longitude Prize for Antimicrobial Resistance (AMR).
AMR, in which the drugs used to treat infections no longer work, is a growing problem. It kills nearly 1.3 million people worldwide every year and is expected to kill 10 million more deaths per year in 2050.
Between 50% and 60% of women will experience this at least one urinary tract infection (UTI) during their lifetime, and to half of the bacteria that cause the infections are resistant to at least one antibiotic. The infections can potentially be fatal sepsis.
However, due to a lack of good, rapid tests, doctors often have to diagnose an infection based on the symptoms and guess which antibiotic will work. The inappropriate use of antibiotics promotes resistance by allowing bacteria to adapt and evade them.
The Longitude Prize was established in 2014 to promote a “cost-effective, accurate, rapid and easy-to-use test for bacterial infections that will enable healthcare professionals worldwide to administer the right antibiotics at the right time.”
The winning one PA-100 AST from Sysmex Astrego system is based on technology from Uppsala University in Sweden. A 400 microliter urine sample is placed on a cartridge the size of a telephone and then into an analysis unit the size of a shoebox. It can spot a bacterial infection within 15 minutes and identify the antibiotic to treat it within 45 minutes.
Previously, doctors would send a sample to a laboratory for testing with results within 24 hours, resulting in a turnaround time of two or three days.
Dr. Tom Boyles, an infectious diseases consultant at Johannesburg’s Helen Joseph Hospital and one of the judges, said most urinary tract infections in South Africa were treated without a sample sent due to time and cost.
“As a result, any patient who does not have a UTI at all is given unnecessary antibiotics, and we ‘shoot blind’ if a UTI is present, and as such we have to use broader antibiotics than would otherwise be necessary. . If we have access to this test, we can solve both problems,” he said, adding that it could be used “in many low-resource settings that can afford it and have a power supply.” He described the test in its current form as an ‘iPhone One’.
“It has the potential to make great strides,” he says. “I’m sure the prize money will be used to upgrade it to an iPhone 10.”
Dr. Sherry Taylor, a partner at the NHS GP in London, said access to the test would “revolutionise” patient care in Britain, where laboratory tests take “about three days”.
About a quarter of infections are resistant to older antibiotics, which are therefore no longer commonly used. The test opens up the possibility that these antibiotics can be brought back.
Dame Sally Davies, member of the Longitude Committee, Britain’s Special Envoy for AMR and former chief medical officer of England, said: “We can no longer afford to prescribe antibiotics just in case.
“The Longitude Prize winner lays the foundation for a transformational change in the way we manage these precious medicines, supporting healthcare professionals with rapid and relevant diagnostic tests to make the best decisions for their patients.”
Mikael Olsson, co-founder of Sysmex Astrego, said the product was being launched in Europe but the prize money would be used to boost cooperation with subsidiaries in Ghana, Burkina Faso and South Africa and reduce production costs.
The test costs around £25 for one cartridge in the private sector, but industry experts say public sector adoption and high volume production could see this drop.
Dr. Katherine Keenan of the University of St. Andrews in Scotland has conducted research into urinary tract infections in Kenya, Tanzania and Uganda. She said the figures recorded in clinics were “the tip of the iceberg”, with many patients buying antibiotics from pharmacies, and that the risk of urinary tract infections was higher in countries with poor sanitation.
Keenan said fair access is critical, with medical advances often unaffordable.
But if it became cheap enough for health care facilities or pharmacies, “there’s no reason why it couldn’t be effective and really, really, really useful,” she said.