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Diagnostics are at the heart of a global AMR solution

Wed, September 14th 2022

Opinion article: Dr Jesus Rodriguez-Manzano, Co-Founder and Chief Scientific Officer (CSO) at ProtonDx, shares his thoughts on anti-microbial resistance (AMR). He discusses what we can learn from the recent COVID‑19 pandemic, including the important role that point-of-need diagnostics can play.

Diagnostics are at the heart of a global AMR solution

I’ve spent my career working in the field of infectious diseases and it is concerning that antimicrobial resistance (AMR) still presents a serious global threat to the prevention and treatment of an ever‑increasing range of infections. AMR occurs when bacteria, viruses, fungi and parasites become resistant to normal treatment options such as antibiotics and other anti‑microbial medicines. Infections eventually become difficult to treat and evolve into ‘superbugs’ that are multi‑ or pan‑resistant to known treatments.

“Rapid and accurate diagnostics need to be at the heart of the global response to AMR.”

Jesus Rodriguez‑Manzano, ProtonDx

AMR increases the risk of disease spread, severe illness and death. The World Health Organization (WHO) has declared it as one of humanity's top 10 global public health threats [1]. The numbers around AMR are staggering. The latest estimate of deaths attributable to AMR is 1.27 million deaths per year [2]. To put that in context, the overall global burden for HIV and AIDS is about 863,000. For malaria, it is 643,000.

With such a grave threat, it is useful for us to look to the recent COVID‑19 pandemic for critical learnings. Our successful response to the COVID19 pandemic has required an unprecedented coordination of research, technology, regulation, infrastructure and the workforce to support the rapid adoption of newly created public health processes. The pandemic has demonstrated ways in which the wider challenge of AMR could be addressed through a similarly concerted and comprehensive effort. The pandemic has also provided insights into the research and policy priorities required to effectively tackle another global threat, such as AMR.

The widespread use of diagnostics and testing has a vital role in helping to improve our understanding of the spread of AMR, including highlighting the importance of surveillance. This could involve, for example, more accurate pinpointing of the location of "hot pockets" of resistance and identification of individual patients with AMR infections. Integrated testing along patient pathways would help us with protecting patients coming into the hospital, facilitating safeguarding and improving patient care. Diagnostics also have an important application in supporting vital clinical decisions, such as the withdrawal of incorrect and/or ineffective antibiotics, and/or the secession of successful treatments.

In March 2022, the Centre for Antimicrobial Optimisation (CAMO) [3] at Imperial College London welcomed Lord Jim O’Neill [4] to the opening of the Department of Health and Social Care / National Institute of Health Research funded CAMO facility. A long‑time high‑profile voice on this issue, Lord O’Neill chaired the influential 2014‑2016 UK Government sponsored Review on Antimicrobial Resistance [5] and has commented passionately on the power of applying appropriate technologies to reduce the issue of AMR permanently. During his visit, he highlighted the importance of interdisciplinary research in the battle against AMR and the availability of a comprehensive set of tools, not limited to new therapeutics but also including diagnostics and the capability to track and trace hot spots.

“Diagnostic testing is not only about therapeutic decision‑making, but also providing the means for surveillance and screening, critical for public health, epidemiology and infection control.”

Professor Alison Holmes, Professor of Infectious Diseases at Imperial College London, Director of the Centre for Antimicrobial Optimisation

At CAMO, my colleagues and I are routinely involved in several initiatives from an advisory perspective, including many AMR‑focused FORUM meetings and roundtables with other experts. Most recently, my colleague, Professor Alison Holmes, participated in a special oral evidence session on antimicrobial resistance [6] in June that was organised through the UK House of Commons Science and Technology Committee (STC). The session was chaired by the Rt Hon Greg Clark MP. The evidence [6] that was subsequently provided to the STC clearly demonstrates how vital our work is.

At ProtonDx, we are focused on developing new test panels to detect AMR pathogens for use on our diagnostic platforms, including our CE‑IVD marked Dragonfly system [7]. Our company recognises the importance of interdisciplinary research and was the first commercial company to rent laboratory space in CAMO. Our involvement with other faculties and businesses at CAMO provides the cross fertilisation of ideas that will ultimately lead to innovative approaches to address AMR.

I’m proud of our brilliant team of multidisciplinary scientists and engineers, and their commitment to developing molecular diagnostics that detect pathogens precisely and rapidly where they are most needed.

Earlier this year at ProtonDx, we were proud to announce that we received a CE‑IVD mark [7] for our innovative Dragonfly rapid diagnostic system. Dragonfly’s 5‑in‑1 Respiratory Test Panel detects Influenza A Virus (IAV), Influenza B Virus (IBV), Respiratory Syncytial Virus (RSV), Human Rhinovirus (HRV), and severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) in a single test. Dragonfly is poised to help revolutionise rapid infectious disease detection and tracking worldwide.

[1] ‑ https://www.who.int/news‑room/fact‑sheets/detail/antimicrobial‑resistance#cms

[2] ‑ https://www.ox.ac.uk/news/2022‑01‑20‑estimated‑12‑million‑people‑died‑2019‑antibiotic‑resistant‑bacterial‑infections#:~:text=The%20analysis%20shows%20AMR%20was,deaths%2C%20respectively%2C%20in%202019.

[3] ‑ https://www.imperial.ac.uk/antimicrobial‑optimisation‑centre/

[4] ‑ https://www.gov.uk/government/people/jim‑oneill

[5] ‑ https://amr‑review.org/

[6] ‑ https://www.parliamentlive.tv/Event/Index/4232b5c1‑b600‑43d9‑ba9e‑af5680c53b7e

[7] ‑ https://protondx.com/news/new‑rapid‑multi‑viral‑diagnostic‑kit‑receives‑ce‑ivd‑mark/