Combatting AMR with Rapid UTI Diagnostics
Combatting AMR with Rapid UTI Diagnostics
Antimicrobial Resistance Awareness Week: Combatting AMR with Rapid UTI Diagnostics
Antimicrobial Resistance (AMR) poses one of the most critical health challenges of our time. Indeed, the World Health Organisation (WHO) has identified AMR as one of the top 10 global health threats (1). Furthermore, in the UK, AMR is recognised on the National Risk Register (2), reflecting the severity of the issue at both national and international levels. With AMR-related deaths reaching 4.95 million globally in 2019 (1), including 1.27 million directly attributed to resistant infections (1), urgent and coordinated action is required to preserve the efficacy of existing antimicrobials.
As part of Antimicrobial Resistance Awareness Week (18–24 November), we are focusing on the critical role of rapid diagnostics in combating AMR. Specifically, we are introducing the Randox Vivalytic UTI Rapid Test as a valuable tool in this global effort. By enabling faster and more accurate detection of infections, this innovative diagnostic technology supports the targeted use of antibiotics, thereby helping to reduce unnecessary prescriptions and mitigate the spread of resistance.
Understanding AMR: The Need for Effective Screening and Targeted Treatment
AMR develops when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist the effects of antimicrobial medicines. While this resistance occurs naturally, it is significantly accelerated by factors such as the overuse and misuse of antibiotics, poor infection control, and the slow pace of new antimicrobial drug development. Consequently, the implications of AMR extend far beyond infection treatment: surgeries, cancer therapies, and routine medical procedures also rely heavily on effective antimicrobials to prevent infections. Therefore, this underscores the pressing need to manage resistance effectively and proactively.
For instance, routine treatments for UTIs heavily depend on antibiotics. UTIs are among the most common bacterial infections, particularly affecting women, with over 50% experiencing a UTI at least once in their lives (3). However, with resistance levels increasing, it becomes crucial to avoid unnecessary antibiotic prescriptions. Additionally, when antibiotics are prescribed, they must be carefully targeted to maximise efficacy and minimise resistance development. In this context, rapid diagnostics play a pivotal role by enabling precise and timely identification of infections, which ensures that treatments are both effective and appropriate.
Introducing the Vivalytic UTI Rapid Test
The Randox Vivalytic UTI Rapid Test offers a cutting-edge solution for the efficient screening and diagnosis of UTIs. Unlike traditional culture methods—which, according to a recent study, take an average of 2.75 days to yield results (4)—the Vivalytic UTI Rapid Test is a cartridge-based PCR test specifically designed for in-clinic use, delivering results in just 2.5 hours. This rapid turnaround is transformative in the management of UTIs, where timely diagnosis is crucial to preventing the progression of infections. Moreover, it helps to minimise unnecessary antibiotic use by ensuring treatment is both prompt and precisely targeted, ultimately supporting the fight against antimicrobial resistance.
Key Features of the Vivalytic UTI Rapid Test:
- Comprehensive Detection: The Vivalytic UTI Rapid Test identifies 16 uropathogens, encompassing both gram-negative and gram-positive bacterial species, in just 150 minutes—significantly faster than traditional culture methods.
- AMR Gene Identification: This advanced test also detects 7 antimicrobial resistance genes, including those conferring resistance to methicillin (mecA) and vancomycin (vanA and vanB), as well as genes associated with trimethoprim resistance (dfrA1, dfrA5, dfrA12, dfrA17). This capability supports targeted treatment decisions and helps in combating antimicrobial resistance.
- Wide Application: Designed for versatility, the test is suitable for various healthcare settings, from GP practices to hospitals. It facilitates UTI diagnosis across diverse use cases, including catheter-associated UTIs and pre-surgical screenings for patients with conditions such as benign prostatic hyperplasia (BPH) or renal stones.
Additionally, a recent study demonstrated that the Vivalytic UTI Rapid Test achieved diagnostic accuracy exceeding 90% for 16 bacterial species, providing a reliable and efficient solution for rapid pathogen identification in UTI cases (4).
The Role of Rapid Diagnostics in Combating AMR
Rapid diagnostic tests, such as the Vivalytic UTI Rapid Test, play a critical role in addressing antimicrobial resistance (AMR) and improving patient care through the following:
- Reducing Misuse of Antibiotics: By rapidly identifying the specific bacteria responsible for the infection and detecting resistance genes, clinicians can prescribe antibiotics only when necessary. This targeted approach ensures that the most effective treatment is selected, helping to combat antibiotic misuse.
- Supporting Antimicrobial Stewardship: Point-of-care testing directly supports the goals outlined in the UK’s AMR 5-Year National Action Plan, which aims to reduce antibiotic consumption by 5% and ensure that 70% of antibiotics are sourced from safer, first-line options (5). Rapid tests enable optimised antibiotic usage, contributing to these national targets and the broader fight against AMR.
- Enhancing Patient Outcomes: Faster and more accurate diagnostics at the point of care enable timely and targeted treatment, reducing the risk of complications such as severe UTI-related kidney infections. Furthermore, a study on the Vivalytic UTI Rapid Test demonstrated that pathogen detection rates were slightly higher when tests were conducted immediately on-site, underscoring the importance of rapid diagnostics in delivering better patient outcomes (4).
AMR and the Future of Healthcare
The rise in AMR jeopardises the future of modern medicine. An estimated 10 million lives could be lost per year by 2050 (6), according to a review commissioned by the UK Prime Minister. Without effective diagnostics and treatments, procedures such as hip replacements, caesarean sections, and cancer therapies could become significantly more dangerous. This is due to the heightened risk of untreatable infections (1). Addressing this escalating threat requires innovation, education, and unwavering commitment.
AMR also imposes immense economic consequences. The World Bank projects that by 2050, AMR could add an extra US$1 trillion to global healthcare costs. It may also cause annual GDP losses ranging from US$1 trillion to US$3.4 trillion as early as 2030 (7). These economic burdens highlight the urgent need for global action.
Addressing AMR is crucial to achieving the Sustainable Development Goals (SDGs) outlined by the United Nations (UN). Progress in areas such as access to clean water, sustainable food production, and responsible antimicrobial use is vital in mitigating AMR. However, rising levels of AMR exacerbate challenges related to health, poverty reduction, food security, and economic growth (8). Coordinated efforts across multiple sectors are essential to tackle this complex issue effectively.
Randox is proud to lead the charge in the fight against antimicrobial resistance (AMR), equipping healthcare professionals with innovative tools such as the Vivalytic UTI Rapid Test. By enabling timely and accurate diagnoses, we contribute to preserving the efficacy of antimicrobials and safeguarding their availability for future generations.
This Antimicrobial Resistance Awareness Week, join us in highlighting the critical importance of AMR management and the transformative role of rapid diagnostics in creating a safer, healthier future for all.
Learn more about the urgency of AMR on the WHO website: Antimicrobial resistance.
For further details about the Vivalytic UTI Rapid Test, visit Vivalytic | UTI Rapid Test | Randox Laboratories or reach out to us at marketing@randox.com.
References
- World Health Organization (2023). Antimicrobial resistance. [online] World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.
- HM Government (2023). National Risk Register 2023 Edition. [online] Available at: https://assets.publishing.service.gov.uk/media/64ca1dfe19f5622669f3c1b1/2023_NATIONAL_RISK_REGISTER_NRR.pdf.
- Bono MJ, Reygaert WC. Urinary Tract Infection. Nih.gov. Published 2018. https://www.ncbi.nlm.nih.gov/books/NBK470195/
- Hartmann, J., Fritzenwanker, M., Imirzalioglu, C., Hain, T., Arneth, B.M., and Wagenlehner, F.M.E., 2024. Point-of-care Testing in Complicated Urinary Tract Infection: Evaluation of the Vivalytic One Urinary Tract Infection Analyser for Detecting Uropathogenic Bacteria and Antimicrobial Resistance in Urine Samples of Urological Patients in a Point-of-care Setting. European Urology Focus. Available at: https://doi.org/10.1016/j.euf.2024.09.018
- Department of Health and Social Care (2024). UK 5-year action plan for antimicrobial resistance 2024 to 2029. [online] GOV.UK. Available at: https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029.
- O’Neill, J. (2016). Tackling Drug-resistant Infections Globally: Final Report and Recommendations. Archives of Pharmacy Practice, 7(3), p.110. doi:https://doi.org/10.4103/2045-080x.186181.
- World Bank (2017). Drug-Resistant Infections: A Threat to Our Economic Future. [online] World Bank. Available at: https://www.worldbank.org/en/topic/health/publication/drug-resistant-infections-a-threat-to-our-economic-future.
- World Health Organization (WHO) (2021). Antimicrobial resistance and the United Nations sustainable development cooperation framework: guidance for United Nations country teams. [online] www.who.int. Available at: https://www.who.int/publications/i/item/9789240036024.
Candida auris: An Urgent Fungal Threat
An Urgent Fungal Threat: Tackling Candida auris in Healthcare Environments
Candida auris (C. auris), is an emerging fungal threat that has garnered global attention due to its multidrug-resistant nature and ability to cause severe, life-threatening infections. First identified in 2009, C. auris has quickly spread worldwide, particularly in healthcare settings, posing a significant challenge to both clinicians and public health professionals.
Understanding Candida auris
Candida auris is a yeast-like fungus that can lead to severe infections, especially in patients with compromised immune systems or underlying health conditions. It is frequently found in healthcare environments such as hospitals and long-term care facilities. The most concerning aspect of C. auris is its ability to persist on surfaces, increasing the risk of outbreaks in these environments. Once introduced into a healthcare setting, it can rapidly spread from one patient to another, making infection control a significant challenge.
In Illinois alone, 921 C. auris cases were confirmed between 2016 and 2022 (1). Additionally, in 2022, 2377 cases of C. auris were reported to the CDC (2), further highlighting the increase in cases each year. In Europe, survey responses were received from all 30 invited EU/EEA countries. From 2013 to 2021, a total of 1,812 Candida auris cases were reported by 15 of these countries. The number of cases nearly doubled from 335 in 2020 to 655 in 2021, indicating a significant increase compared to previous years (3).
C. auris primarily causes bloodstream infections, but it can also infect wounds, the respiratory tract, and the ear. Patients in critical care, especially those using invasive medical devices such as ventilators, catheters, or feeding tubes, are particularly susceptible. In fact, data indicates that more than one in three people with an invasive C. auris infection affecting the blood, heart, or brain, do not survive (1).
The Growing Threat of Multidrug Resistance
One of the major concerns surrounding C. auris is its resistance to multiple classes of antifungal medications, which are typically used to treat Candida infections. This multidrug resistance often leads to treatment failure and poor outcomes in affected patients. In addition to its drug resistance, Candida auris is often misidentified as other Candida species using standard laboratory methods, further delaying appropriate treatment.
The Importance of Rapid and Accurate Detection
Given the risks posed by Candida auris, rapid detection is crucial for preventing the spread of this dangerous fungus. Early identification allows healthcare professionals to implement strict infection control measures such as isolating patients, cleaning and disinfecting affected areas, and preventing further transmission within healthcare facilities. However, traditional detection methods may be slow and prone to misidentification, making timely response difficult.
Enter Vivalytic
The early identification and containment of Candida auris are essential to prevent large-scale outbreaks. This is especially important in healthcare environments where patients may be vulnerable. The Vivalytic’s rapid detection of C. auris colonisation and infection allows for earlier implementation of infection control measures. This reduces the burden on public health systems and helps save lives.
At Randox Laboratories, the focus is on advancing the detection of infectious diseases like Candida auris. The Vivalytic, developed with Bosch, offers a reliable and accurate testing solution. This supports healthcare providers in protecting patients and controlling the spread of the fungus. Real-time PCR technology is used by the Vivalytic Candida auris test to detect DNA from swabs. These swabs may be taken from the axilla, groin, nasal, or rectal regions.
Key Benefits of Vivalytic Testing for Candida auris:
- Quick Results: The Vivalytic provides results in under 1 hour, enabling healthcare providers to make swift, informed decisions about patient care and infection control. This quick turnaround is essential for both treating the patient and containing the spread of Candida auris within a healthcare facility.
- Simple, 4-Step Process: The test uses a convenient 4-step process, from scanning the sample to receiving the results, making it easy to use in both laboratory and non-laboratory settings. The system’s fully automated, cartridge-based platform minimises the risk of contamination and simplifies workflow.
- Accurate Detection: The real-time PCR method used by Vivalytic ensures precise detection of Candida auris, even in cases where traditional methods might misidentify the fungus. This accuracy is vital in initiating appropriate antifungal treatment and curbing the infection.
- Convenient for Various Settings: The Vivalytic platform is designed to be used in a wide range of settings, from large laboratories to point-of-care environments, making it versatile and adaptable to the needs of different healthcare providers.
| Detectable Pathogens |
|---|
| Candida auris |
References
- dph.illinois.gov. (n.d.). Candida auris (C. auris). [online] Available at: https://dph.illinois.gov/topics-services/diseases-and-conditions/infectious-diseases/candida-auris.html.
- CDC (2024). Tracking C. auris. [online] Candida auris (C. auris). Available at: https://www.cdc.gov/candida-auris/tracking-c-auris/index.html.
- Kohlenberg, A., Monnet, D.L. and Plachouras, D. (2022). Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021. Eurosurveillance, 27(46). doi:https://doi.org/10.2807/1560-7917.es.2022.27.46.2200846.
Rapid Tests / Serology Reagents
Introduction to Serology
Serology tests are used for the detection of antibodies in the blood in order to diagnose an active or previous infection, or to determine disease of the immune system such as autoimmune disorder. There are various types of serologic tests, each to diagnose a different disease; some include Anti-Streptolysin-O, Rheumatic factor, Syphilis and CRP.
Antibodies enable identification of past or present infection
Antibodies are formed by the body in response to infection against foreign proteins called antigens. Antigens enter the body via the mouth, nasal passages or through broken skin. Upon doing so the body’s immune system defends the body by producing antibodies, particles that attach to the antigens to deactivate them. Serology tests identify the type of antibodies and antigens present in the blood and determine the type of infection the patient may have or may have had in the past. Serology tests can also determine immunity to a certain organism.
Serology tests include:
Anti-Streptolysin O used to determine recent streptococcal infection caused by the streptococcus bacteria. Infections can be mild or severe, varying from throat infections, cellulitis, sinusitis, impetigo and middle ear infections to life-threatening infections of the blood or organs such as pneumonia, meningitis and sepsis. In addition this test also helps identify the presence of post streptococcal complications including rheumatic fever which causes inflammation of the joints or heart, and glomerulonephritis which refers to damage of the glomeruli (tiny filters in the kidneys). The latter are rare and are caused by the body’s immune system attacking healthy body tissue in response to streptococcus bacteria.
CRP used to detect inflammation, infection and tissue injury of the liver. CRP (C-reactive protein) is a protein produced by the liver in response to inflammation, infection and tissue injury; it is released into the blood within a few hours and therefore the CRP test enables quick detection of trauma or infection. It can be used together with consideration of signs and symptoms to diagnose the condition causing the infection or inflammation, in addition to being useful in monitoring the treatment of people with chronic inflammatory conditions.
Rheumatoid factor used to help diagnose rheumatoid arthritis and distinguish it from other forms of arthritis or conditions causing similar symptoms. Rheumatoid factors are antibodies produced by the body’s immune system that can attack healthy tissue in the body. Symptoms of rheumatoid arthritis include pain, stiffness in the joints (particularly in the morning), and, swelling, warmth and redness.
Syphilis (RPR and TPHA) used to screen for the Treponema pallidum bacteria which causes syphilis, a chronic, contagious and often congenital venereal disease. The 2 types of tests we use include Rapid Plasma Reagin (RPR) and T. pallidum particle agglutination assay (TPHA).
RPR is a non-treponemal antibody test which detects antibodies not specifically directed against the Treponema pallidum bacteria; these are produced by the body in response to several conditions including syphilis and are therefore non-specific. Such tests are highly sensitive, however, and the RPR test can also be used to monitor the treatment of syphilis.
TPHA test is a treponemal l antibody test used to detect antibodies specifically directed against the Treponema pallidum bacteria; these are highly-specific for the detection of syphilis.
Treponemal (syphilis specific) antibodies remain in the blood for life, whereas non-treponemal (non-syphilis specific) antibodies typically clear the blood after approx. 3 years following successful treatment; therefore following a positive treponemal test result, a non-treponemal antibody test may be used to determine between an active syphilis infection/reinfection, or a past infection which has been successfully treated.
Rapid tests include:
Randox Pregnancy test used for early confirmation of pregnancy by identifying Human Chorionic Gonadotrophin (hCG) in urine; hCG is a hormone released by the cells of a developing placenta shortly after conception. Levels of hCG are detectable in urine in the first week after conception, therefore making it an excellent marker for early confirmation of pregnancy.
Randox pregnancy test is highly sensitive, able to detect hCG concentrations as low as 25mlU/ml, and produces results in 3 minutes. In addition a variety of methods and kit sizes provide choice and enhances suitability.
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