A single lateral flow test strip could soon identify which bacteria are causing a urinary tract infection and indicate the right antibiotic to use, all within minutes rather than days. This matters because UTIs are among the most common infections and a major reason antibiotics are prescribed in the community. Overuse and mis-prescription of antibiotics are driving antimicrobial resistance, making existing drugs less effective. Current diagnosis relies on laboratory culture and microscopy, which typically takes several days. During that wait, patients often receive broad-spectrum antibiotics that may be unnecessary or incorrect. If this research succeeds, a cheap, rapid test could be used in care homes, GP surgeries, or even by patients themselves at home. The result would be reported directly to the patient record, allowing clinicians to prescribe the right antibiotic immediately. This would reduce unnecessary antibiotic use, slow the spread of resistance, and improve outcomes for elderly and immobile patients who struggle to access lab-based testing. The project also includes a health economic study to determine how such tests could fit into existing care pathways, and works with a diagnostics company to design a practical platform.
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Antimicrobial resistance represents a global challenge that requires a paradigm shift in healthcare to resolve. Antibiotics are becoming less effective due to increased resistance associated with their overuse and mis-prescription. There is a demand not only to develop new antimicrobial compounds but to improve diagnosis and prescribe only as required, and specific to the pathogen. Urinary tract infections (UTIs) are among the most common types of infections and are a significant cause of mortality, especially among the elderly population with 4835 deaths in England and Wales reported in 2012. UTI is the main indication of community antibiotic prescriptions and costs the NHS >£124 million pa. Many patients are in care home settings or have poor mobility and hence the ability to undertake and remote test, and report the results directly to the patient record would represent a significant advance for infection diagnosis and treatment. This proposal seeks to build on the public understanding, and general acceptance, of lateral flow tests (LFTs) to develop a test for bacterial infection. The LFT readout will consist of multiple bands (of a different colour) to improve diagnostic accuracy, as well as to identify the type of bugs responsible for the infection. In summary, we propose to: 1. Develop new targeting agents to recognise the bacterial species responsible for UTIs 2. Develop novel gold nanomaterials that provide strong readouts in the presence of the bacteria 3. Validate a multiplexed device - capable of identifying multiple species in a single test 4. To determine the diagnostic accuracy of the test. 5. To work with patients, care workers, clinicians and SureScreen Diagnostics to design and implement a UTI LFT detection platform. 6. Undertake Health economic study to determine where/how the devices can integrate into the UTI care pathway. 7. Validate LFTs on patient samples and compare to the current gold standard (laboratory culture and microscopy- and typically takes several days)
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