The utility of molecular testing has been unleashed in the current COVID-19 pandemic, with RT-PCR becoming a household name.
Molecular tests are increasingly relevant in diagnosing infections due to their high accuracy and efficiency. Image credit: SeqGen
Between 18 and 24 November each year, World Antimicrobial Awareness Week (WAAW) is observed to raise awareness of the critical health problem of antibiotic resistance and encourage people around the world to handle antibiotics with care. It also recommends best practices among the public, healthcare professionals and policy makers to prevent the emergence and spread of drug-resistant infections. Antimicrobial resistance (AMR) is among the ten most relevant global public health threats humanity faces, according to the World Health Organization (WHO).
Antimicrobials include antibiotics, antivirals, antifungals, and antiparasitics that fight bacteria, viruses, fungi and parasites, respectively. Antimicrobial resistance occurs when these insects resist the effects of drugs and develop the ability to overcome drugs designed to kill them. This makes common infections more difficult to treat and increases the risk of disease, serious illness and death. Some of the major antimicrobial resistance factors include:
- excessive and improper use of antibiotics,
- inappropriate prescription after misdiagnosis of infection,
- lack of hygiene and hygiene in humans and animals,
- poor prevention of infections and diseases e
- intensive use of antibiotics in agriculture.
Molecular tests such as RT-PCR, multiplex PCR, and genome-based tests can provide a quick and accurate diagnosis. These tests not only identify the microbe causing the infection, but can also offer information about the insect if it is resistant to antimicrobials. This knowledge helps the doctor make an informed decision about treatment and prevent drug resistance. The utility of molecular tests such as RT-PCR has been published in the current COVID-19
pandemic. This test has become a household name for COVID-19 but the utility of molecular tests such as these has not yet been recognized for other infections that require rapid diagnosis. These infections include sepsis, meningitis, encephalitis where accurate diagnosis and the choice of antibiotics are essential to save lives. In addition to detecting the organism, RT-PCR is also used to quantify the amount of organism present in the clinical sample. In hepatitis C infection, knowledge of the viral load in the clinical specimen is critical for monitoring treatment.
it’s just a trailer of what an out-of-control antibiotic-resistant pathogen could do. Image Courtesy: Healthline
Drug-resistant infections spread rapidly during international travel and migrations, although their impact is felt slowly, so unlike COVID-19
, Antimicrobial resistance is a silent pandemic with long-term implications for global health. In the fight against antimicrobial resistance, genome-based techniques can play a central role. These tests promise to overcome the shortcomings of conventional techniques such as cultivation, which takes time and effort.
“We recently had a case where a 52-year-old woman suffered from autoimmune pancytopenia, which meant she had lower than normal immunity, which made her prone to infections. After observing an abscess on his right leg, he immediately started taking antibiotics and we sent the blood culture sample, which was negative. However, I wanted to be doubly sure, so I sent the pus sample for multiplex PCR testing to (our laboratory) in Bangalore, “said Dr. Sachin Jadhav, a renowned oncologist from Bengaluru.
“The results showed the presence of Salmonella and thus confirmed the diagnosis of a rare typhus infection. Based on the diagnosis, the antibiotic prescription was changed and the woman recovered within 2 weeks. Without the clarity offered by multiplex PCR, accurate prescribing of antibiotics would not have been possible and this would have led to a greater chance of antibiotic resistance, ”added Jadhav.
Techniques such as Next Generation Sequencing (NGS) use knowledge of the microbe’s genome. As in the case of tuberculosis, where the greatest challenge is multi-drug resistance.
“Last year, we launched our proprietary SPIT-SEQ test, a sputum-based direct genome-wide sequencing test to diagnose and profile drug resistance in pulmonary tuberculosis in one go,” said Dr. . Ramprasad VL, CEO of MedGenome Labs. “With multiple applications of NGS in infectious diseases, we are poised to impact the use of antimicrobials and the management of infectious diseases. “
The author is the senior scientist (infectious diseases) of MedGenome Labs Ltd, Bangalore.
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