In a world-first discovery that could save millions of lives, a research team in Western Australia has developed a method to detect a bacterial infection in hours instead of days, and identify effective antibiotic treatment.
A team from the Harry Perkins Institute of Medical Research, University of Western Australia and PathWest Laboratory Medicine has developed the faster process, which should help address antibiotic resistance.
If not treated adequately, bacterial infections can lead to sepsis, which can be fatal.
Harry Perkins Institute microbiologist Kieran Mulroney made the announcement in Perth.
"For serious infections, getting the right antibiotic for the patient is a time-critical emergency," Dr Mulroney said.
"A patient that doesn't have effective antimicrobial therapy has an increased risk of death, 6.7 per cent for every hour without an appropriate antibiotic.
"We've discovered a new method that allows us to predict whether there is a bacterial infection and whether or not an antimicrobial will be effective in only five hours as opposed to the two to five days it currently takes to get results."
The new method involves two steps. The first is a test to confirm whether the cause of a serious illness is a bacterial infection, and this takes only half an hour.
The bacteria is then exposed to different types of antibiotics.
A device that measures hundreds of thousands of individual bacteria in a matter of seconds helps determine how successful the antibiotics have been.
"What we can do is use lasers to actually get all the way down to the very tiniest resolution and to be able to measure each bacterial cell, so we can look at each cell in the sample and tell what the antibiotic is doing to them rather than having to wait for those millions of cells to see what the effect looks like," Dr Mulroney said.
The growth of antimicrobial resistance is a major global health issue, with estimates that 1.27 million people die from resistant infections each year.
This could reach 15 million by 2050, potentially overtaking cancer as the leading cause of death.
"When we're looking at that 1.27 million every year, even if we touch 10 per cent of that, in the next decade, those numbers stack up really quickly.
"We're looking at avalanches of hundreds of millions of deaths over the next decades.
"Those numbers will probably be tens of millions [less] for any test that can get in there and give doctors the right tool at the right time."
The findings have been published in the Lancet eBioMedicine journal.
'Stuff-up' led to discovery
Medical microbiologist and team member Tim Inglis said he'd been working on sepsis and its diagnosis since the 1980s.
"This quite obviously is the most exciting development in my entire career," Dr Inglis said.
"Because we really haven't made a big dent in significant clinical outcomes from sepsis over those last three to four decades."
Dr Inglis described himself as the one who made the first "laboratory error" some years ago, which led to the eventual outcome.
"If I'm perfectly honest, it was 'oh dear, I've stuffed up here'.
"Pulled the wrong reagents from the reagent fridge, I made an observation that was at first, difficult to explain, that led to some very interesting observations that were then built on."
He said it helped them understand the need to observe the behaviour of bacteria in the very early stages of treatment with antibiotics "to get a fast answer".
"Recognising that we can achieve both speed and accuracy in a short period of time was the breakthrough," he said.
Discovery should help combat resistance
Perth renal physician and team member Aron Chakera said being able to tackle resistance would be a key benefit of the new method.
"We're seeing common antibiotics that we may have used to treat relatively simple infections now no longer being effective, that results in patients potentially needing to have intravenous options," Dr Chakera said.
"And now increasingly [we're seeing] patients [for whom] there aren't actually good options, or we're having to come up with new ways of trying to manage those infections because all of our traditional options are gone.
"We now need to really increase our community awareness that actually, if this is not a significant infection, then you really should not be having antibiotics.
"The risk of antibiotics down the track in terms of driving resistance is potentially huge."
The team needs to go through regulatory approvals before the new tests can be widely used.
