Antimicrobial Resistance

Thread Bioscience supports antibiotic stewardship. 

Resistance to antibiotics occurs when bacteria evolve into strains not experiencing mortality from drugs designed to kill them. When patients become infected with these “superbugs,” the drugs are no longer effective.

The World Health Organization (WHO) has published several global reviews of antimicrobial resistance, including antibiotic resistance. The first report was released in 2014 and  was compiled from 114 countries. The WHO concluded antibiotic resistance  poses a serious threat to public health for the entire global population. You can read the entire report here. The WHO’s Global Action Plan on Antimicrobial Resistance discusses findings from global data collected in the year following the initial report.

Dr. Keiji Fukuda, assistant director-general for Health Security at the World health Organization (WHO), states in the report:

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill.”

Antibiotics have helped us to live longer, healthier lives, says Dr. Fukuda, but unless we act now and bolster efforts to prevent infection, plus change how we produce, prescribe and use antibiotics, we will lose those benefits and “the implications will be devastating.”

The report finds many different agents of infection are becoming resistant to treatment, it focuses on bacteria that are responsible for some of the most common serious conditions.  Today’s Standard of Care in treating suspected Urinary Tract Infections is identified as one of the leading contributors to this global health issue.

Urinary Tract Infections (UTI’s) are among the most common bacterial infections both globally and in the United States along with sepsis, bloodstream infections, pneumonia, diarrhea and gonorrhea. Testing for UTI’s  forms a significant part of the workload in clinical microbiology orders. The current testing methods are tedious due to transportation logistics and the amount of time between when the sample is taken and results are received. Test results can take anywhere from 24 to 36 hours for negative results and as much as 48 -60 hours if the first test is positive.

Enteric bacteria (in particular, Escherichia coli) remain the most frequent cause of UTI’s. Scientists have recently discovered the distribution of pathogens that cause UTI’s is changing as bacteria evolve and adapt.

More important is the increase in resistance to some antimicrobial agents, particularly the resistance to trimethoprim-sulfamethoxazole seen in E. coli.

Since good medical practice is to fight a suspected infection as quickly as possible antibiotics may be prescribed for a suspect case that is actually negative. When the physician receives the results and notifies the patient of the negative results many patients will stop taking the antibiotic prior to the completion of the entire prescription.

Even though the physician or someone from the office will instruct the patient to continue taking the entire prescribed amount many patients only hear they have a negative result. They think they no longer need to take any further medication.

This is a prime environment for bacteria to mutate and adapt as result of the uncompleted antibiotic course and eventually develop greater antibiotic resistance. Additionally, even in patients that do as instructed and continue to take the entire prescribed amount they are completing a course of medication they did not require. This may have  a negative impact on the patient’s beneficial bacteria.

Thread’s technology is addressing this issue. CultureStat provides a comprehensive testing platform incorporating multiple data sources providing fast, accurate results. CultureStat can detect bacteriuria provide results in fast as 1 hour with suspect results requiring an additional hour for confirmation. This reduction in time  to receive accurate results provides a path to minimizing antibiotic prescriptions prior to test results.

Between 50 and 70 percent of UTI tests sent to laboratories are negative.  The test result is not provided until 24-48 hours after being sent to the lab.

The technical limitations and time constraints of test strips and agar plating, the current gold standard testing technology, are contributing to the prescribing of unnecessary antibiotics.

CultureStat is an automated rapid test system that detects bacteriuria in-situ. CultureStat is a  Point Of Care methodology utilizing proprietary media to accurately and rapidly measure cell mass and respiration. CultureStat differentiates between lag phase and log phase states and indicates the absence or presence of bacteriuria.

Antibiotics currently being used against bacterial infections:

Gentamicin (Gentak)
Nitrofurantoin (Macrobid)
Cefazolin
Ceftriaxone (Rocephin)
Cefuroxime (Ceftin)
Cefotetan (Cefotan)
Cefixime (Suprax)
Ceftazidime (Fortaz)
Cefotaxime (Claforan)
Cefadroxil (Duricef)
Sulfamethoxazole / Trimethoprim (Bactrim)
Trimethoprim (Primsol)
Ciprofloxacin (Cipro)