Identification and Differentiation of Viral and Bacterial Respiratory Infection to Guide Antibiotic Stewardship

The development of point-of-care testing is critical in the identification and differentiation between bacterial and viral respiratory infections. Defining the indications of infection to improve antibiotic stewardship, ensures that patients are protected from unnecessary antibiotic use and antibiotic resistance. It has been shown that particular protein biomarkers, such as myxovirus resistance protein (MxA) and C-reactive protein (CRP), differentiate infections between bacterial and viral. Using point-of-care platforms, such as Randox’s VeraSTAT, for detection of these protein biomarkers may provide more rapid and cost-effective discriminating tools.

The treatment of bacterial and viral infections can differ significantly, however people are often treated with empirical antibiotics due to a lack of paid and accurate testing. Although early intervention of infection is urgent, current diagnostic methods are either time intensive or inaccurate. The challenges clinicians are faced with in the differentiation of viral or bacterial respiratory infection can lead to delayed diagnosis, misappropriation of antibiotics and increased healthcare costs.

MxA protein has the potential to greatly enhance the rapid detection of viral respiratory infections as it increases significantly when there is actuate viral infection. CRP is the dominant acute phase protein often used to guide treatment of a bacterial infection or inflammation associated with tissue injury, inflammatory disorders, and associated diseases.

CRP & MxA together, allow clinicians to make appropriate decisions in supporting antimicrobial stewardship and guide the appropriate use of antibiotics, saving time performing unnecessary tests, providing unnecessary treatment which missing the opportunity to provide the right treatment in a timely manner.

The Randox VeraSTAT is a simple, accurate, portable point of care device which delivers rapid results via the use of patented cathodic electrochemiluminescence technology (C-ECL). Designed with the aim of offering users the next generation of rapid diagnosis, the VeraSTAT eliminates the requirement to send samples to a laboratory and instead returns results in as little as 6 minutes.

Eliminates delays in sending samples to the lab and facilitate immediate decision making at the point of care.
Lightweight, portable and convenient, the Randox VeraSTAT can be used in a variety of locations to deliver results as required, such as a GP surgery or Emergency Department.
Intuitive user interface guides the operator through the entire testing process.
All necessary reagents are conveniently included in each single use, sealed cassette with no preparation required. All necessary consumables are supplied with the kit.
The Randox VeraSTAT allows for results to be exported via Bluetooth connectivity.
Flexible test menu comprising of a range of immunoassay, protein, inflammatory, diabetes & infectious disease markers.

Novel testing approaches identifying the type of infection at the point of care are essential in accurately guiding appropriate antibiotic treatment. Although these tests can’t determine what type of viral or bacterial infection a patient has, it will determine whether the infection is viral or bacterial, further testing is then carried out to determine what type of pathogen the patient has via PCR – the gold standard. The ability to distinguish between viral and bacterial infections is the most effective guide for clinical decision making and is an innovative tool for antibiotic stewardship.

References

1 – Fleming-Dutra K.E., Hersh A.L., Shapiro D.J. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315:1864–1873. doi: 10.1001/jama.2016.4151.

2 – Cals JW, Hopstaken RM, Butler CC, Hood K, Severens JL, Dinant GJ. Improving management of patients with acute cough by C-reactive protein point of care testing and communication training (IMPAC3T): study protocol of a cluster randomised controlled trial. BMC Fam Pract. 2007;8:15.

3- New report calls for urgent action to avert antimicrobial resistance crisis [Internet]. World Health Organization. World Health Organization; 2019

4 – Hutchings MI, Truman AW, Wilkinson B. Antibiotics: past, present and future. Curr Opin Microbiol. (2019) 51:72–80. doi: 10.1016/j.mib.2019.10.008

For more enquiries please contact the Marketing team: market@randox.com

Learn more about VeraSTAT

Today, Northern Ireland’s Chief Medical Officer Dr. Michael McBride has stated that antibiotic resistance is now the greatest risk to human health and medicines worldwide. Dr. McBride said; “Currently 700,000 people die worldwide each year from drug resistant infections and this figure is forecasted to reach 10 million deaths by 2050, if the problem is ignored.”

It is rather alarming therefore that 70% of GPs admit that they prescribe antibiotics when they are unsure if they are treating a viral or bacterial infection. By prescribing antibiotics for viral infections, which can’t be combatted with antibiotics, patients are being exposed to antibiotics which are of no benefit.

John Lamont, Lead Scientist at Randox Laboratories, said that “Current diagnostic testing for respiratory infections takes at least 36 hours to confirm the nature of an infection, and they cannot name and categorise infections as bacterial or viral is the way our new respiratory test can.”

At Randox, our pioneering R&D teams have developed a revolutionary swab test for respiratory infections which indicates the cause of the infection and whether a patient needs antibiotics or not. This helps to limit the amount of patients who are prescribed antibiotics, reducing antibiotic resistance.

The Randox test, which can rapidly detect and identify the cause of 21 respiratory infections in just 5 hours, can also subsequently determine the appropriate antibiotic drug treatment for patients.

This test, if adopted by GP surgeries, could allow medical practitioners to make the correct treatment choice on the same day as examination and before patients have already begun a precautionary course of inefficient antibiotics. It would also have additional efficiency savings for the NHS, by eliminating the need for lengthy microbiology lab tests and unnecessarily prescribing drugs which are not needed. This new rapid and accurate test will give the GP confidence in their diagnosis of respiratory infections and will allow for quicker treatment if necessary, which benefits patient outcomes.

The test is also available as a Randox Health Cough, Cold & Flu offering, and can be carried out by booking an appointment with Randox Health at our clinics in Crumlin, Holywood or London, or by arranging the mobile clinic to visit you at your home or place of work.

So what action can we take to limit the looming antibiotic resistance crisis?

Ask your GP if tests will be performed to make sure you even need antibiotics and that the correct antibiotic is prescribed.
Take the antibiotics as prescribed. Make sure you complete the prescribed course, even when you start feeling better. This makes sure that all bacteria from your current infection are eradicated, leaving none behind that could potentially develop resistance to your antibiotic.
Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Taking the wrong medication will delay correct treatment and allow bacteria to multiply, and potentially develop a resistance to the antibiotic you are using incorrectly.

Find out more about the Cough, Cold & Flu Respiratory test here.

Book an appointment with one of our clinics, or arrange the mobile clinic, by phoning 0800 2545 130 or by clicking here.

For further information please contact the Randox PR team by email: randoxpr@randox.com or phone 028 9442 2413