The utility of molecular testing has been launched within the present COVID-19 pandemic, with RT-PCR changing into a family title.
Between 18 and 24 November every year, World Antimicrobial Awareness Week (WAAW) is noticed to lift consciousness concerning the vital well being problem of antibiotic resistance, and encourages individuals throughout the globe to deal with antibiotics with care. It additionally recommends finest practices amongst the general public, well being staff, and policymakers to keep away from additional emergence and unfold of drug-resistant infections. Antimicrobial resistance (AMR) is amongst the ten most pertinent international public well being threats that humanity is confronted with, in keeping with the World Health Organisation (WHO).
Antimicrobials embrace antibiotic, antiviral, antifungal and antiparasitic medicines which battle towards micro organism, viruses, fungi and parasite respectively. AMR happens when these bugs resist the consequences of medicines and develop the power to defeat the medicine designed to kill them. This makes frequent infections more durable to deal with and rising the chance of illness unfold, extreme sickness and dying. Some main drivers of AMR embrace:
- the overuse and misuse of antibiotics,
- inappropriate prescribing after misdiagnosis of an infection,
- lack of sanitation and hygiene in each people and animals,
- poor an infection and illness prevention, and
- in depth use of antibiotics in agriculture.
Molecular check like RT-PCR, multiplex PCR and entire genome-based assay can present correct and fast prognosis. These check not solely determine the microbe inflicting the an infection but additionally can provide perception into the bug whether it is immune to antimicrobials. This data helps clinician to make an knowledgeable remedy determination and in flip stop drug resistance. The utility of molecular check like RT-PCR has been launched within the present COVID-19 pandemic. This check has turn into a family title for COVID-19 prognosis, nevertheless the usefulness of molecular exams like these have nonetheless not been acknowledged for different infections which warrant fast prognosis. These infections embrace sepsis, meningitis, encephalitis whereby exact prognosis and selection of antibiotics is paramount for lifesaving. Apart from detecting the organism, RT-PCR can also be used to quantitate the quantity of organism current within the medical specimen. In Hepatitis C an infection, data of viral load within the medical specimen is essential for monitoring the remedy.
Drug-resistant infections unfold quickly via worldwide journey and migration, though its influence is felt slowly, therefore not like COVID-19 , AMR is a silent pandemic with long-term implications for international well being. In the battle towards AMR, genome-based strategies can play a pivotal position. These exams have the promise to beat the shortfalls of standard strategies like culture- which is time-consuming and laborious.
“We recently had a case where a 52-year-old lady was suffering from auto-immune pancytopenia, which meant she had a lower than normal immunity, which made her prone to getting an infection. On observing an abscess on the right leg, she was immediately started on antibiotics, and we sent the sample for blood culture, which came out to be negative. However, I wanted to be doubly sure, and hence I sent the pus sample for multiplex PCR testing to (our lab) in Bangalore,” stated Dr Sachin Jadhav, a number one oncologist from Bengaluru.
“The results showed presence of Salmonella and hence confirmed the diagnosis of a rare typhoid infection. Based on the diagnosis, the antibiotic prescription was altered, and she recovered in 2 weeks. Without the clarity that multiplex PCR offered, the precise antibiotics prescription would not have been possible and that would have led to increased chances of antibiotic resistance,” Jadhav added.
Techniques reminiscent of Next-Generation Sequencing (NGS) use the data of the genome of the microbe. Like in case of tuberculosis, the place the most important problem is multi-drug resistance.
“Last year, we launched our proprietary SPIT-SEQ test – a direct sputum-based whole genome sequencing test for diagnosing and profiling drug resistance in pulmonary tuberculosis in one go,” stated Dr Ramprasad V L, CEO of MedGenome Labs. “With multiple applications of NGS in infectious diseases, we are poised to make an impact on antimicrobial use and infectious disease management.”
The writer is the Principal Scientist (Infectious Diseases) at MedGenome Labs Ltd, Bangalore.