A new blood test has been developed by clinical researchers at the NIHR Imperial Biomedical Research Centre (BRC), to make it easier for doctors to determine what type of infection a patient has. This could mean that effective treatments are prescribed more efficiently.
When patients typically arrive in A&E with a suspected infection, identifying the kind of infection they have - including whether the infection is viral or bacterial – causes difficulty. Some of the challenges are due to patients not spending enough time in hospital to become enrolled in a clinical trial, meaning that developing new tests for acute infectious diseases can be tough.
Researchers have since identified three specific genes which signal the presence of a virus. This has been discovered because they are triggered when a virus infects the body. The findings were published this week in The Lancet Microbe.
The new test measures levels of the three genes through blood samples from the BioAID database. This pattern then lets doctors know if the patient has a viral or bacterial infection. Treatment can then be tailored to patients more effectively, as well as specific tests administered to identify the type of virus. Patient samples are collected when they arrive to A&E, and therefore the database relies on the support of clinical teams taking blood, as well as the patients and their relatives, who provide consent for samples to be included in the study.
Senior Author of the study, Professor Shiranee Sriskandan, an honorary consultant in infectious diseases at Imperial College Healthcare NHS Trust (ICH), and Professor of infectious diseases at Imperial College London, said: “Currently, if a patient arrives at hospital with a suspected infection, there is no reliable test available that can answer the initial question of whether the infection is likely to be bacterial or viral; tests we relied on previously have been unreliable with Covid-19.
“Tests also exist for individual infections, such as we have seen extensively used in recent months for Covid-19, but when the nature of the specific infection is unclear, it can be very difficult to narrow down without multiple tests.
“Clearly, if we can identify whether the infection is viral or bacterial in the first instance, we can target individualised treatments more effectively to improve outcomes for patients and ensure those who will not benefit from antibiotics are not receiving them unnecessarily.”
The new test would also mean that in a pandemic, doctors would be able to decide earlier which patients to isolate inside rooms, whilst providing an early indication of how many patients might be infected, well before any specific test for a new virus is available. The study showed that the test identified patients effectively with viral infections, including the novel coronavirus.
Professor Sriskandan, added: “As we plan for future pandemics, the way in which we manage infectious disease will no doubt need to evolve and we hope that by continuing to collaborate with NIHR Biomedical Research Centres across the country, our work will help clinical teams to better manage infections and treat patients more quickly.”
The test is hoped to be converted quickly in to a ‘point of care’ test, which could be conducted when patients arrive in A&E. It is expected to help improve the care of patients arriving with suspected infection, with the potential to support primary care.
The database provides access to patient samples that are collected for the purpose of studying acute infection. BioAID is a collaborative project between the NIHR BRC at ICH, University College Hospital, Oxford University Hospitals and University Hospitals Birmingham.