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CAMBRIDGE / UK: A team of scientists and doctors from the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust have developed a DNA test they say will quickly identify secondary infections in Covid patients -19, who have twice the risk of developing pneumonia while on ventilation.
For patients with the more severe forms of Covid-19, mechanical ventilation is often the only way to keep them alive, as doctors use anti-inflammatory therapies to treat their inflamed lungs. However, these patients are susceptible to other infections caused by bacteria and fungi that they can contract in the hospital, research shows.
A team of scientists and doctors from the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, led by Professor Gordon Dougan, Dr Vilas Navapurkar and Dr Andrew Conway Morris, have developed a simple DNA test to quickly identify these infections and target antibiotic treatment as needed.
The test, developed at Addenbrooke’s Hospital in collaboration with Public Health England, gives doctors the information they need to start treatment in hours rather than days, adjusting treatment as needed and reducing inappropriate use of antibiotics.
This approach, based on higher throughput DNA testing, is being rolled out in Cambridge University Hospitals and offers a path to better treatments for the infection in general. The results are published in the journal Critical Care.
Patients who need mechanical ventilation are at significant risk of developing secondary pneumonia while in intensive care. These infections are often caused by bacteria resistant to antibiotics and are difficult to diagnose and require targeted treatment.
“At the start of the pandemic, we noticed that patients with Covid-19 seemed particularly at risk of developing secondary pneumonia and started using a rapid diagnostic test that we had developed for such a situation,” said the co-author, Dr Andrew Conway. Morris of the Cambridge Department of Medicine and critical care consultant.
Patients with Covid-19 are believed to be at an increased risk of infection for several reasons. Due to the extent of lung damage, these severe cases of Covid-19 tend to spend more time on a ventilator than patients without Covid-19. Moreover, many of these patients also have poorly regulated immune systems, where immune cells damage organs, but also have impaired antimicrobial functions, increasing the risk of infection.
Normally, confirming a diagnosis of pneumonia is difficult, as bacterial samples from patients must be grown and cultured in a laboratory, which is time consuming. The Cambridge test takes an alternative approach by detecting DNA from different pathogens, resulting in faster and more accurate testing.
The test uses a multiple polymerase chain reaction (PCR) which detects the bacteria’s DNA and can be done in about four hours, which means you don’t have to wait for the bacteria to grow.
The test – which was developed with Dr Martin Curran, a PCR diagnostics specialist at Public Health England’s Cambridge lab – runs multiple PCR reactions in parallel and can simultaneously detect 52 different pathogens, which often infect the lungs of patients in care intensive. At the same time, it can also test for antibiotic resistance.
“We found that even though patients with Covid-19 were more likely to develop secondary pneumonia, the bacteria responsible for these infections were similar to those in intensive care patients without Covid-19. This means that standard antibiotic protocols can be applied to Covid-19 patients. Said lead author Mailis Maes, also from the Department of Medicine.
This is one of the first times that this technology has been used in routine clinical practice and has now been approved by the hospital. Researchers predict that similar approaches would benefit patients if used more widely.
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For patients with the more severe forms of Covid-19, mechanical ventilation is often the only way to keep them alive, as doctors use anti-inflammatory therapies to treat their inflamed lungs. However, these patients are susceptible to other infections caused by bacteria and fungi that they can contract in the hospital, research shows.
A team of scientists and doctors from the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, led by Professor Gordon Dougan, Dr Vilas Navapurkar and Dr Andrew Conway Morris, have developed a simple DNA test to quickly identify these infections and target antibiotic treatment as needed.
The test, developed at Addenbrooke’s Hospital in collaboration with Public Health England, gives doctors the information they need to start treatment in hours rather than days, adjusting treatment as needed and reducing inappropriate use of antibiotics.
This approach, based on higher throughput DNA testing, is being rolled out in Cambridge University Hospitals and offers a path to better treatments for the infection in general. The results are published in the journal Critical Care.
Patients who need mechanical ventilation are at significant risk of developing secondary pneumonia while in intensive care. These infections are often caused by bacteria resistant to antibiotics and are difficult to diagnose and require targeted treatment.
“At the start of the pandemic, we noticed that patients with Covid-19 seemed particularly at risk of developing secondary pneumonia and started using a rapid diagnostic test that we had developed for such a situation,” said the co-author, Dr Andrew Conway. Morris of the Cambridge Department of Medicine and critical care consultant.
Patients with Covid-19 are believed to be at an increased risk of infection for several reasons. Due to the extent of lung damage, these severe cases of Covid-19 tend to spend more time on a ventilator than patients without Covid-19. Moreover, many of these patients also have poorly regulated immune systems, where immune cells damage organs, but also have impaired antimicrobial functions, increasing the risk of infection.
Normally, confirming a diagnosis of pneumonia is difficult, as bacterial samples from patients must be grown and cultured in a laboratory, which is time consuming. The Cambridge test takes an alternative approach by detecting DNA from different pathogens, resulting in faster and more accurate testing.
The test uses a multiple polymerase chain reaction (PCR) which detects the bacteria’s DNA and can be done in about four hours, which means you don’t have to wait for the bacteria to grow.
The test – which was developed with Dr Martin Curran, a PCR diagnostics specialist at Public Health England’s Cambridge lab – runs multiple PCR reactions in parallel and can simultaneously detect 52 different pathogens, which often infect the lungs of patients in care intensive. At the same time, it can also test for antibiotic resistance.
“We found that even though patients with Covid-19 were more likely to develop secondary pneumonia, the bacteria responsible for these infections were similar to those in intensive care patients without Covid-19. This means that standard antibiotic protocols can be applied to Covid-19 patients. Said lead author Mailis Maes, also from the Department of Medicine.
This is one of the first times that this technology has been used in routine clinical practice and has now been approved by the hospital. Researchers predict that similar approaches would benefit patients if used more widely.
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