Following a decade of developments, and entries from more than 250 teams around the world, the £8m Longitude Prize on AMR has been awarded by Challenge Works (part of innovation agency Nesta) to the PA-100 AST System from Sysmex Astrego.
The Longitude Prize on AMR was launched in 2014 to incentivise the creation of new diagnostic tests that, in a matter of minutes, can identify whether an infection is bacterial, enabling the right antibiotic to be prescribed. The goal was to replace the 2-3 day lab test process that doctors and patients must currently endure, and end “just in case” prescribing that is prevalent as a result, which promotes the development of antibiotic resistance.
The PA-100 AST System is an innovative diagnostic test based on technology from Uppsala University. The test aims to transform the treatment of UTIs (urinary tract infections) and bring the power of laboratory testing into a doctor’s office. Using a tiny (400 microlitre/less than half a millilitre) sample of urine on a smartphone-sized cartridge, the test can identify the presence of a bacterial infection in just 15 minutes and accurately identify the right antibiotic to treat it within 45 minutes.
This supports doctors and health workers in their clinical decision making at the point of care, and opens up the significant possibility of previously “retired” first-line antibiotics coming back into use for the majority of patients.
Dame Sally Davies, UK Special Envoy on Antimicrobial Resistance, former Chief Medical Officer of England and Longitude committee member said: “Without antibiotics, modern medicine as we know it is in real danger of collapse. Every day, healthcare workers make urgent clinical judgements for the good of their patients, but we can no longer afford ‘just-in-case’ prescribing of antibiotics.
"The Longitude Prize winner lays the groundwork for a sea-change in how we manage these precious medicines, where healthcare workers are supported with rapid and relevant diagnostic tests to make the best decisions for their patients with confidence that they are prescribing the right drug, first time.”
Mikael Olsson, CEO and co-founder, Sysmex Astrego, winners of the Longitude Prize on AMR said: “The PA-100 AST System challenges bacteria present in a patient’s urine with microscopic quantities of antibiotics in tiny channels embedded in a cartridge the size of a smartphone.
"We rapidly pinpoint whether a bacterial infection is present and identify which antibiotic will actually kill the bugs, guiding doctors only to prescribe antibiotics that will be effective. We have already started rolling out the test in Europe, we’re running studies in surgeries across the UK and working with regulators to secure additional approvals.
"The £8m prize will support us to tailor the test for use with different kinds of UTIs and antibiotics, speeding up access for more patients.”
Dr. Sherry Taylor, GP Partner at NHS practice Temple Fortune Medical Group in London said: “Currently I send the urine sample off for analysis and it usually takes around three days to come back with results, if we get results back that differ to our prescription then we have to ring the patient back to change them to the correct antibiotic. Having a bedside test that would enable rapid diagnosis through antibiotic susceptibility testing would revolutionise general practice and patient care. It would be amazing – it’s all about using antibiotics only when necessary and appropriate.”
The cartridge, containing a nanofluidic chip, is inserted into an analyser unit – about the size of a shoebox – which reads the chip sample at a cellular level. Designed to work in doctor’s offices, the analyser unit is fully automatic and maintenance free. It is the first time a point-of-care test is capable of identifying a specific infection and its susceptibility to specific drugs by observing how the patient’s infection responds in real-time to different antibiotics (a phenotypic test).
The PA-100 AST System creates a future where patients can quickly and accurately get a diagnosis and the correct treatment when they visit the doctor. Accurate, rapid diagnosis of bacterial infections that help doctors and health workers to manage and target antibiotics, will slow the development and spread of antibiotic resistant infections, improve healthcare and save potentially millions of lives.
Roughly 25-30% of patients have infections resistant to older first-line antibiotics which have been retired as a result; this means the remaining 70-75% of patients could still benefit from those older drugs. Since the PA-100 AST System identifies which specific antibiotic can treat an infection, it will likely allow retired antibiotics to be brought back into service because the test is able to demonstrate when an infection is susceptible to their effects.
For more on the Longitude Prize on AMR, visit longitudeprize.org
