How to survive in the hospital: Don’t get Candida auris
The New York Times recently published an intriguing article on a new and emerging super-bug called Candida auris which is resistant to many commonly used anti-microbial drugs. C. auris is a fungus, a type of yeast. If C. auris enters the bloodstream, it can cause a life-threatening condition called sepsis. The mortality rate of C. auris bloodstream infections is approximately 50%. A subsequent NY Times article detailed the tragic case of a woman in Chicago who contracted a C. auris bloodstream infection.
C. auris is a particular concern to the medical community because of its common resistance to anti-fungal drugs and its ability to develop drug-resistance while patients are being treated. Senate minority leader Charles “Chuck” Schumer recently called on the CDC to declear superbug Candida auris a public health emergency. Additionally, C. auris persists in the local hospital environment where infected patients are treated. For instance, it is difficult to eliminate from the beds, drapes, curtains, ceiling tiles, and other surfaces of hospital rooms, where it can potentially spread to other patients and healthcare workers.
Current Laboratory methods used to diagnose C. auris bloodstream infections lack the sensitivity needed for early detection of the organism, determination of what drugs would be most effective at treating C. auris and at what concentrations they should be given — a process called phenotypic antibiotic susceptibility testing or AST. Identification and AST takes days using current techniques. New technologies, like T2 Biosystems® (TTOO), T2Candidemia® panel can’t identify C. auris and lack the capability to provide rapid phenotypic AST.
What’s needed are new tools to rapidly develop novel diagnostics and which have the capability to not only identify emerging pathogens like C. auris, but also perform rapid phenotypic antibiotic susceptibility testing so the patient gets the right drug, in the right dose at the right time in order to treat deadly bloodstream infections like that caused by C. auris. New diagnostics should be rapid to deliver information to physicians in a meaningful time period; they should be sensitive and capable of early detection; and they should be cost-effective to enable adoption in any country and in any economy.
Nuclease Probe Technologies has developed a rapid, logical, and systematic approach for the development of assays that detect particular microbial pathogens. Proteins produced by bacteria and fungi like C. auris digest our proprietary detection probes which releases a fluorescent marker. NPT measures fluorescence to identify the presence of infection and subsequently incubates the patient specimen with antimicrobial therapies to determine the most effective treatment using gold standard laboratory methods of phenotypic antimicrobial susceptibility testing. This method can be used to develop assays for virtually any pathogen and test a wide variety of antimicrobial compounds to see what will work and what won’t.
NPT’s detection probes can be integrated into a variety of formats depending on the intended use and work environment. The probes can be incorporated into simple substrates like standard microbiological cultivation media to vastly decrease the time needed for detection, or into lateral flow assays, and incorporated as part of a reagent kit and instrument system using standard laboratory equipment. NPT’s assays utilize proteins produced by bacteria and fungi like C. auris that are enzymatic in nature. NPT leverages the natural abundance of these enzymes to achieve great sensitivity at low cost. Using our tried and true assay development method, NPT is creating a suite of assays for the detection of common bloodstream pathogens that cause the majority of sepsis cases, and our methods provide detection and antimicrobial susceptibility testing to get the patient on the right treatment in hours versus the 3 to 5 days required to date.
NPT’s technology has been extensively peer reviewed in significant publications like Nature Medicine and others. A 2016 PLOS One study by Burghardt et al, “Rapid, Culture-Free Detection of Staphylococcus aureus Bacteremia”, compared NPT’s technology versus the gold standard laboratory method of blood culture and found that NPT’s method was 100% sensitive and 97% specific with a negative predicative value of 100%. NPT delivered these results in 3 hours vs. an average 33 hours required for laboratory results. Our publications can be viewed here.
Nuclease Probe Technologies is responding to the global crises of emerging, drug resistance pathogens like C. auris and other bacteria with our systematic method for rapid assay development which we use to create simple tests which can dramatically shorten the time to treatment with effective antimicrobials. Early intervention has been shown to make patients better quicker, reduce the amount of time spent in the hospital, and reduce overall hospital expenses. If you’re interested in learning more visit us at www.nptrapidtesting.com, or drop us a note at bd@nptrapidtesting.com.
