Point of Care: Speeding up the diagnosis for infection

Ben Mooney has a background in cheese-making involving microbiology and biotech.  He has joined forces with St Vincent’s Co-Director of Immunology Research, Professor Kumar Visvanathan, in a research project that would speed up the diagnosis for infection.

During his 17 years running the family cheese business, Ben Mooney was often struck by the sight of his highly skilled cheese makers packing stock, or driving forklifts.

‘I thought ‘hang on’, this isn’t right,’ Ben says. ‘I started to think about what processes I had in place to ensure that I was maximising the time of my most skilled workers and minimising the tasks that aren’t valuable. I became increasingly interested in the concept of quality systems.’

Ben’s commitment to improving work processes led him to return to university to study advanced manufacturing technology.

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Ben Mooney and Professor Kumar Visvanathan

With a cheese-making background involving microbiology and biotech, and his newly acquired knowledge of system processes, Ben began looking for ways to combine his interests. He became interested in biodevices which led him to seek out St Vincent’s Co-Director of Immunology Research, Professor Kumar Visvanathan.

‘In my discussions with Kumar, we kept coming back to the issues around delays in identifying causative organisms in sepsis,’ Ben says. Sepsis is a potentially life-threatening complication of an infection.

‘Sepsis is still responsible for around 50% of deaths in Intensive Care, and with the emergence of resistant organisms, that number is trending up,’ Prof Visvanathan says.

‘When someone is showing signs of sepsis, it is important that they are treated immediately with the appropriate antibiotic. On the flipside of that, though, is making sure that antibiotics are not given to patients who don’t need them.’

It’s a race against time – a four-hour window for treatment, when laboratory tests can take 24-48 hours. When doctors suspect sepsis, they can’t afford to wait for the lab results; they will begin administering antibiotics. If the lab tests come back negative, this delay in diagnosis can contribute to antibiotic resistance.

There are hand-held sequencers, currently in beta testing, that have the potential to quickly diagnose sepsis using purified bacteria DNA from a patient blood sample. Previously the cost of running a sequencer has made their use prohibitively expensive in a clinical setting, but these hand held devices are driving down the cost and time delay of sequencing.

‘The issue at the moment is extracting bacterial DNA from a patient’s blood sample so that this kind of technology can be leveraged,’ Ben says. The PhD student is looking to weld two different disciplines together to come up with a solution to this pressing clinical problem. ‘If we can get a handful of bacteria out of blood, get the DNA, and amplify that DNA and sequence that, then we will quickly be able to know the bacteria’s name, species and strain,’ he says.

‘At the moment we are dreaming of what may be possible in a few years’ time, but this does seem the way of the future,’ Prof Visvanathan says. ‘If we can get it, a correct diagnosis at the bedside would make a huge difference. We may also be able to identify antimicrobial resistant genes, which will further help in designing an effective therapeutic response.’

Although Ben’s aim is to develop a disposable point-of-care device, if a process for quickly purifying DNA could be established, this breakthrough could be as important as the device.

‘We may be able to commercialise that process through a service business, or it may be information that hospitals, including St Vincent’s, can use in the way they structure their microbiology labs,’ Ben says.

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