A new DNA-sequencing device the size of a USB stick could be used to treat urinary tract infections (UTIs).
The groundbreaking new device, dubbed MinION, performs nanopore sequencing to characterize bacteria collected from urine samples four times more quickly than conventional culture methods, the University of East Anglia reported. The new method is also able to detect antibiotic resistance in UTI-associated bacteria.
"Urinary tract infections are among the most common reasons for prescribing antibiotics. Most are mild and only affect the lower urinary tract, but a few are more troublesome. These 'ascending' UTIs cause a growing burden of [hospitalizations], mostly of elderly patients," said David Livermore, from UEA's Norwich Medical School.
In worst case scenarios, the infection will enter the bloodstream, leading to a potentially fatal condition called urosepsis. There were at least 30,000 cases of Escherichia coli bloodstream infection recorded in England in 2014 alone.
Urosepsis requires immediate treatment, and it takes over two days for lab cultures to determine which antibiotics will treat the infection. As a result, doctors generally prescribe a wide range of antibiotics to these patients, potentially leading to antibiotic resistance. This can also mean patients infected with antibiotic resistant strains of the bacteria will go undertreated.
"This 'carpet-bombing' approach represents poor antibiotic stewardship, and it is vital that we move beyond it. The way to do so lies in accelerating laboratory investigation, so that treatment can be refined earlier, benefitting the patient, who gets an effective antibiotic, and society, whose diminishing stock of antibiotics is better managed," Livermore urged.
The new Nanopore MinION from Oxford Nanopore Technologies could help solve this problem by quickly investigating UTIs without taking the time to culture bacteria. The device can provide the bacteria's DNA sequence in as little as 12 hours.
"Swift results like these will make it possible to refine a patient's treatment much earlier - and that's good for the patient, who gets the 'right' antibiotic, and for society - which can better manage or 'steward' its limited supply of antibiotics," said Justin O'Grady, also from UEA's Norwich Medical School. "This technology is rapid and capable not only of identifying the bacteria in UTIs, but also detecting drug-resistance at the point of clinical need."
The researchers noted that at this time the device can only be used on highly infected urine and can't predict resistances that arise by mutation, but the technology is rapidly developing and the limitations will likely be overcome in the near future.
The findings were presented by the American Society for Microbiology's Interscience Conference of Antimicrobial Agents and Chemotherapy (ICAAC) and the International Society of Chemotherapy (ICC).
