This month, we focus on the work of Professor Peter Wilson, consultant microbiologist at UCLH. In a collaboration between HSL and UCLH’s critical care and microbiology teams, Professor Wilson is leading a trial of a new diagnostic test designed to exclude bacteraemia in critically ill patients.
There has been widespread concern in the last two years concerning the spread of multi-resistant Gram-negative bacteria across the UK. Some of these pathogens are resistant to all antibiotics. Unfortunately, infection prevention measures are only partially effective. In a move to combat this growing problem, Dame Sally Davies, Chief Medical Officer, has encouraged the development of diagnostic kits that might help to scale down the use of antibiotics.
Professor Wilson and colleagues have recently completed a trial designed to help reduce the length of antibiotic courses used in the treatment of the critically ill patients. The test, developed by Momentum Bioscience Ltd, was performed on blood cultures collected from patients admitted to ICU, and detected with 99.5% accuracy those samples where there were no organisms (bacteria or fungi) present. Although in this study the results were not used to alter treatment, intensive care consultants were asked at the time if the test result would have changed management.
The test was performed blinded in the environmental microbiology laboratory at UCLH after the sample had been incubated for 12 hours. Careful collaboration was required between the environmental laboratory, critical care and HSL to allow the samples to be processed without affecting routine testing in any way. The original recruitment projection was two patients a week, but with the help of the blood culture laboratory at HSL and Dr David Brealey of critical care, an average of five patients a week were recruited. In total, 120 patients were recruited in six months, finishing in June. The results are now being analysed, and should provide some valuable insights into how antibiotics are used in ICU, and the role that diagnostics has to play in preventing lengthy antibiotic treatment.