Rapid, Multiplexed, Testing for Urinary Tract Infections

抗菌素耐药性是一项全球性挑战，需要医疗保健领域的范式转变来解决。由于过度使用和处方不当导致的耐药性增加，抗生素的效果正在变得不那么有效。人们不仅需要开发新的抗菌化合物，而且需要改进诊断，只根据需要开出针对病原体的处方。尿路感染是最常见的感染类型之一，是死亡的重要原因，特别是在英格兰和威尔士2012年报告的4835例死亡的老年人口中。UTI是社区抗生素处方的主要适应症，花费了NHS&GT；GB 1.24亿pa。许多患者在疗养院环境中或行动不便，因此进行和远程测试的能力，并将结果直接报告到患者记录将代表着感染诊断和治疗的重大进步。这项建议旨在建立在公众对侧向流动试验(LFT)的理解和普遍接受的基础上，开发一种细菌感染测试。LFT读数将由多条带(不同颜色)组成，以提高诊断准确性，并识别导致感染的细菌类型。综上所述，我们建议：1.开发新的靶向试剂，以识别导致UTIS2的细菌种类。开发新的金纳米材料，在细菌存在的情况下提供强大的读数。验证多路设备-能够在一次测试中识别多个物种4.确定测试的诊断准确性。与患者、护理人员、临床医生和SureScreen诊断公司合作，设计和实现UTI LFT检测平台。进行卫生经济研究，以确定设备可以在哪里/如何集成到UTI护理路径中。验证患者样本上的LFT，并与当前的黄金标准(实验室培养和显微镜检查-通常需要几天)进行比较

Antimicrobial resistance represents a global challenge that requires a paradigm shift in healthcare to resolve. Antibiotics are becoming less effective due to increased resistance associated with their overuse and mis-prescription. There is a demand not only to develop new antimicrobial compounds but to improve diagnosis and prescribe only as required, and specific to the pathogen.Urinary tract infections (UTIs) are among the most common types of infections and are a significant cause of mortality, especially among the elderly population with 4835 deaths in England and Wales reported in 2012. UTI is the main indication of community antibiotic prescriptions and costs the NHS >£124 million pa. Many patients are in care home settings or have poor mobility and hence the ability to undertake and remote test, and report the results directly to the patient record would represent a significant advance for infection diagnosis and treatment.This proposal seeks to build on the public understanding, and general acceptance, of lateral flow tests (LFTs) to develop a test for bacterial infection. The LFT readout will consist of multiple bands (of a different colour) to improve diagnostic accuracy, as well as to identify the type of bugs responsible for the infection.In summary, we propose to:1. Develop new targeting agents to recognise the bacterial species responsible for UTIs2. Develop novel gold nanomaterials that provide strong readouts in the presence of the bacteria3. Validate a multiplexed device - capable of identifying multiple species in a single test 4. To determine the diagnostic accuracy of the test.5. To work with patients, care workers, clinicians and SureScreen Diagnostics to design and implement a UTI LFT detection platform.6. Undertake Health economic study to determine where/how the devices can integrate into the UTI care pathway.7. Validate LFTs on patient samples and compare to the current gold standard (laboratory culture and microscopy- and typically takes several days)