12th June 2024

Following a decade of developments, and entries from more than 250 teams around the world, the £8m Longitude Prize on AMR has been awarded by Challenge Works (part of innovation agency Nesta) to the PA-100 AST System from Sysmex Astrego.

The announcement is accompanied by a report from Challenge Works: ‘Implementing rapid diagnostic tests for UTI in the UK healthcare system’. The research, which consulted expert clinicians, academics, and patients, makes recommendations as to how this groundbreaking test could be realistically integrated into the NHS.

Deputy Chief Executive, Michael Corley and Director of Public and Professional Engagement, Dr Nick Brown, from BSAC, contributed to the report, which outlines how innovative diagnostic technology for UTIs could be integrated into the NHS.

The Longitude Prize on AMR launched in 2014 to incentivise the creation of new diagnostic tests that, in a matter of minutes, can identify whether an infection is bacterial, and if so, the right antibiotic to prescribe to slow the spread of antibiotic resistant infections. The goal was to replace the 2-3 day lab test process that doctors and patients must currently endure, and end “just in case” prescribing that is prevalent as a result, which promotes the development of antibiotic resistance.

The PA-100 AST System is an innovative diagnostic test based on technology from Uppsala University. The test will transform the treatment of UTIs (urinary tract infections) and brings the power of laboratory testing into a doctor’s office.

Using a tiny (400 microlitre/less than half a millilitre) sample of urine on a smartphone-sized, the test can identify the presence of a bacterial infection in just 15 minutes and accurately identify the right antibiotic to treat it within 45 minutes. This supports doctors and health workers in their clinical decision making at the point of care, and opens up the significant possibility of previously “retired” first-line antibiotics coming back into use for the majority of patients.

Antimicrobial Resistance (AMR) – also known as antibiotic resistance or superbugs – is a silent, growing and devastating pandemic where bacteria have developed resistance to the lifesaving antibiotics at the heart of modern medicine, following a century of unnecessary or untargeted prescriptions. In 2019, antibiotic resistant infections directly killed 1.3m people around the world and contributed to the deaths of 5m in total. By 2050 it is predicted antibiotic resistant infections will cause 10m deaths annually. Around 50-60% of women will develop a UTI in their lifetime, and one in 10 women aged 18 and over report at least one presumed UTI annually. UTIs are the most common bacterial infection treated by the NHS in England – and up to half of infection-causing bacteria are resistant to at least one antibiotic.

The cartridge, containing a nanofluidic chip, is inserted into an analyser unit – about the size of a shoebox – which reads the chip sample at a cellular level. Designed to work in doctor’s offices, the analyser unit is fully automatic and maintenance free. It is the first time a point-of-care test is capable of identifying a specific infection and its susceptibility to specific drugs by observing how the patient’s infection responds in real-time to different antibiotics (a phenotypic test).

The PA-100 AST System creates a future where patients can quickly and accurately get a diagnosis and the correct treatment when they visit the doctor. Accurate, rapid diagnosis of bacterial infections that help doctors and health workers to manage and target antibiotics, will slow the development and spread of antibiotic resistant infections, improve healthcare and save potentially millions of lives.

Dr Nick Brown, Consultant Medical Microbiologist, Cambridge University Hospitals NHS Trust said:

“Management of UTIs is built around custom and practice and not-well-evidenced, and is often based on evidence from several decades ago.

“What we really need is a model for intervention that works and is viable economically but also in terms of professional practice.”

The Longitude Prize on AMR recognised and focused on the need for diagnostics as part of a complimentary, coordinated approach for AMR.

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