Point-of-care infection identification system in 30 minutes - tackling acute pneumonia in emergency rooms and intensive care units

在英国，每年有50万急诊患者因急性肺炎就诊。可悲的是，老年人（65岁以上）占以肺炎为主要诊断的总死亡人数的50%。在急诊科，诊断肺炎的黄金标准是进行自动胸片检查（CXR），它可以将肺炎与其他呼吸道感染区分开来。在对严重程度评分较高的老年患者进行评分后，确诊为老年急性肺炎（GAP），患者几乎总是按照GAP指南给予广泛的抗生素或抗生素鸡尾酒治疗。从临床医生的角度来看，CXR或CT扫描是确认肺炎诊断的有力工具；然而，在大多数情况下，它不能确定肺炎的来源。肺炎的来源因当地感染模式的不同而有很大差异。对于医生来说，确定感染源是实施有效治疗的关键，即病毒性感染不能用抗生素治疗，细菌性感染不能用抗真菌药物治疗，真菌感染不能用抗病毒药物治疗。目前对病原体身份的诊断测试至少需要1 - 2天。在急诊室（er）和重症监护病房（icu），个体可在急性耐药感染后4 - 12小时内死亡。由于诊断结果的周转时间较慢，医生被迫采用经验性治疗，这往往导致抗生素治疗范围超出必要范围，甚至开错抗生素。事实上，64.5%的耐药感染患者被错误地给予了错误的抗生素，导致住院时间、费用和死亡率显著延长。我们的技术承诺从临床样本直接进行物种鉴定的时间小于30分钟。目前，打乱并显著改善患者预后的机会是引入即时护理（POC）系统，医生可以直接区分感染是真菌、细菌还是病毒。这将大大降低护理的经验性，将数百种可用的治疗方案减少到15 - 20种，并显著增加选择最佳治疗方案的机会。有了我们的技术，我们将能够向前迈出一大步，确定致病微生物的确切种类。这将进一步减少治疗选择从15 - 20到理论上2 - 5，完全改变护理的结果。

Every single year, acute pneumonia is responsible for 500,000 ER visits in the UK. Sadly, the elder demographic (\\\> 65 years old) constitutes > 50% of the total deaths with pneumonia as the primary diagnosis. In an emergency department, the gold standard for diagnosing pneumonia is to perform an automated chest radiograph (CXR) which can distinguish pneumonia from other respiratory tract infections. Upon assigning an elder patient with a high severity score, geriatric acute pneumonia (GAP) is confirmed and the patient is almost always administered broad-based antibiotics or an antibiotic cocktail in line with the GAP guidelines.From the point of view of a clinician, CXR or CT scans are powerful tools that confirm the diagnosis of pneumonia; however, it does not identify the source of pneumonia in most circumstances. The source of pneumonia vary wildly depending on the local infection pattern. It is crucial for physicians to determine the source of infection to administer the effective treatment, i.e., viral infections cannot be treated with antibiotics, bacterial infections cannot be treated with antifungal drugs, and fungal infections cannot be treated with anti-viral drugs.Current diagnostic tests for a pathogen's identity take at least 1 - 2 days. In emergency rooms (ERs) and intensive care units (ICUs), individuals can die within 4 - 12 hours of an acute resistant infection. With the slow turnaround time for diagnostic results, doctors are forced to treat with empirical therapy, which often leads to broader than necessary antibiotic therapy or even an incorrect antibiotic being prescribed. In fact, 64.5% of patients with resistant infections are incorrectly administered the wrong antibiotics resulting in a significantly longer length of stay, cost, and death rate.Our technology promises a time-to-result of <30 minutes for species identification directly from a clinical sample. The opportunity to disrupt and significantly improve patient outcomes today is to introduce a point-of-care (POC) system where the doctor can directly differentiate whether the infection is fungal, bacterial, or viral. This would dramatically reduce the empirical nature of care, cutting down hundreds of available treatment options to 15 - 20 options and significantly increasing the chance of selecting the optimal treatment. With our technology, we will be able to go a big step further and identify the exact species of the disease-causing microbe. This would further reduce the treatment options from 15 - 20 to theoretically 2 - 5, completely transforming the outcome of care.