News
Bacterial vesicles prove important testing ground for new antibiotics
The membrane is the bacteria’s most important line of defense against our antibiotics. When it sheds part of that defense, the discarded leftovers now prove to be key players in our fight against antibacterial resistance.
In the relentless battle against antibiotic resistance, scientists are continually seeking innovative strategies to combat drug-resistant infections. Today we found a clever way to study how antibiotics interact with bacteria, and the interesting part is that bacteria themselves gave us a hint on how to do it.
- Now we are making strides in tackling the antibacterial resistance crisis by developing new methods to understand how new antibiotics work, says researcher Maxim Bril'kov.
Read the whole story in the Research corner at uit.no
Published: 08.04.2024
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Study: New sepsis test provides faster and reliable results
Doctors at The Helgeland Hospital Trust in Arctic Norway received test results two days earlier than before, when they tested a new way to analyze blood samples for suspected sepsis. This could mean life or death for patients at your local hospital.
Do you know anyone who has had sepsis? Chances are you do. In fact, every year some 49 million cases and 11 million sepsis-related deaths occurred worldwide in 2017, according to a study reported by the WHO. This accounts for 20 percent of all global deaths.
It goes without saying that it is crucial to get quick and accurate answers on which bacteria have entered the patient's blood, so that doctors can promptly administer the correct antibiotics to stop the infection. This is where two doctors from Northern Norway have confirmed a diagnostic breakthrough.
Important for small acute care hospitals
Hege Harboe-Sjåvik at Helgeland Hospital Trust and Kristoffer Hammer Endresen at Nordland Hospital Trust, in collaboration with CANS – Centre for New Antibacterial Strategies at UiT The Arctic University of Norway, examined a new analysis method for detecting bacteria in blood.
The BCID2 method was used at several smaller hospitals during the coronavirus pandemic to analyze COVID-19 tests, but it has not yet been used for rapid analysis of sepsis in Norway.
The doctors' goal was to check if this new and fast method works just as well at smaller hospitals, compared to sending samples for analysis at a large laboratory at a bigger hospital.
This would be a significant step in the right direction for faster and better patient treatment for suspected sepsis at local hospitals. It is important for smaller hospitals, which are often far from the large laboratories, to find out which bacteria are behind an infection so that they can more quickly administer the correct antibiotics.
Faster analyses - equally good results
The researchers reviewed the results from 160 blood samples with bacteria taken at Helgeland Hospital Trust in Mo i Rana, Sandnessjøen, and Mosjøen from July to December 2021. Rapid tests were performed at the various local hospitals, while the standard tests were carried out at a microbiological laboratory at the regional hospital in Bodø.
It turned out that the doctors in Helgeland both received the test results two days earlier than before, and they were almost as accurate as the tests done at the large laboratory in Bodø where the bacteria were cultured in the usual way.
The new method also revealed the possibility of providing better antibiotic treatment for the patient in one out of four cases.
“The conclusion is that this is a robust and accurate addition to traditional diagnostics for detecting bacteria in blood samples quickly. The method offers great potential for more targeted antibiotic use at local hospitals”, says Kristoffer Hammer Endresen.
“This is an innovative solution with great potential for better treatment and equitable services at local hospitals. Two days faster test results can have a significant impact on seriously ill patients at local hospitals. This can provide a more equitable patient service, without the need for patients or healthcare personnel to be moved between hospitals”, says Hege Harboe-Sjåvik at the Helgeland Hospital Trust.
"These are important findings for a growing patient group at local hospitals”, says Hege Harboe-Sjåvik.
“The results show great opportunities for more accurate antibiotic use, and that this is a tool with great potential to reduce unnecessary use of broad-spectrum antibiotics at local hospitals. This is important in the fight against antibiotic resistance”, explains Kristoffer Hammer Endresen at the Nordland Hospital Trust.
There were just under three percent of cases where the new test failed to detect the bacteria that were present in the blood. And there were no cases where the rapid test indicated the presence of bacteria in the blood when there actually were none, so-called false positives.
References
"FilmArray (BCID2) provides essential and timely results in bloodstream infections in small acute care hospitals without conventional microbiology services"
https://onlinelibrary.wiley.com/doi/10.1111/apm.13374
WHO sepsis key facts:
https://www.who.int/news-room/fact-sheets/detail/sepsis
Contact Information
Hege Harboe-Sjåvik
Medical Director, Helgeland Hospital Trust
hege.harboe-sjavik@helgelandssykehuset.no
Kristoffer Hammer Endresen
Senior Physician at the Diagnostic Clinic, Nordland Hospital Trust
kristoffer.endresen@nordlandssykehuset.no
Proper antibiotic use leads to less antibiotic resistance
To increase the chances of a patient's recovery, it is extremely important that the antibiotics given are effective against the bacteria that have invaded the body. However, it is not necessarily best to administer so-called broad-spectrum antibiotics that kill a wide range of bacteria, as this contributes to the development of antibiotic resistance.
Being able to target antibiotic treatment against the responsible bacteria as early as possible, while minimally affecting the beneficial bacteria in the body, is very important to ensure that antibiotics remain effective in the future.
Facts about antibiotic resistance
Antibiotic resistance occurs when bacteria change in a way that antibiotics can no longer kill them, making infections harder to treat. Overuse and misuse of antibiotics are two major reasons why bacteria develop resistance.
Antibiotic resistance is one of the greatest global threats to public health. New treatment options seem to be far off, and in the meantime, it is very important to implement multiple measures to slow down the development of resistance to the antibiotics we have today.
At CANS – Centre for New Antibacterial Strategies at UiT The Arctic University of Norway, research is being conducted on new ways to attack bacteria, how bacteria evolve, and how we should use antibiotics more responsibly.
Facts about BCID2 and FilmArray
BCID2 is a type of test used to quickly determine which bacteria or yeast are present in the blood of patients who may have a bloodstream infection. BCID stands for BioFire Blood Culture Identification. The test is analyzed in a machine called FilmArray, and what is special about this test is that it can provide results very quickly – usually within an hour.
The test works by taking a small amount of the blood culture, that is, blood that has already shown signs of containing microbes, and examining it for genetic material (DNA or RNA) that is specific to different types of bacteria and yeast. It can also look for genes that may make the bacteria resistant to antibiotics.
Because the BCID2 test is so fast, it can help doctors choose the right antibiotics for treatment much earlier than traditional methods.
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Cancer drugs and AMR: Painting the whole picture
Using cancer drugs is necessary but may actually lead to more antibiotic resistance. It is a catch 22, but CANS researchers are about to uncover the extent of the problem – and the possible solutions.
Now, with fresh funding from the Northern Norway Regional Health Authority, she will take the project a big leap forward and further investigate the connection between AMR and a number of other cancer drugs. Starting now, she will be analysing at which concentrations, and in which combinations of drugs, those drugs become an AMR problem to look out for.
- Building on data that I already collected for my PhD, when I tested 73 different cancer drugs against 11 different resistance genes in bacteria, we will finally be able to properly address the extent of the problem, researcher Jónína Guðmundsdóttir says.
The results will inevitably be highly relevant for the future treatment of cancer patients, who rely heavily on antibiotics to fight off infections when they go through surgery, chemotherapy, and radiation treatment.
Avoiding the catch 22
In proving which cancer drugs, or combinations of drugs, that can cause AMR, Guðmundsdóttir could be likely to come up with clinically relevant knowledge about which drugs to be careful with.
- If we can say that cancer treatment A leads to resistance to antibiotic B in bacteria, then clinicians could try to avoid treating patients undergoing treatment A with antibiotic B and rather go straight for antibiotic X that has the same effect, but where pre-existing AMR should not be a problem.
In three years from now, we should have a much clearer picture of which drugs are the drivers of this next to impossible catch 22 of cancer treatment:
For the benefit of the patients you are damned if you don’t use the drug, but when it comes to antibiotic resistance you may be damned if you do…
Contact information
Jónína Guðmundsdottir
Jonina.gudmundsdottir@uit.no
Phd thesis
Cancer drugs as drivers of antibiotic resistance
https://munin.uit.no/handle/10037/30482
Video: Cancer chemotherapy can lead to antibiotic resistance
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