Increasing the speed of infectious disease diagnostics

Identifying pathogens faster

Correctly and efficiently identifying diseases such as influenza can lead to a more rapid treatment, but currently methods of successfully diagnosing an infectious disease can take several days or even weeks.

However a Cambridge-based company is developing a way to do it as quick as possible, even within a day, by reading the DNA sequence of identified pathogens and other viruses.

The company called Pathogenica states that it is developing diagnostic tests that will be able to correctly identify infectious diseases by targeting the genes responsible for harmful effects and resisting drug treatment.

Starting by targeting the bacteria responsible for urinary tract infections, Pathogenica hopes to have a product approved by the U.S. Food and Drug Administration by the end of 2012, with a target of $10 per test.

DNA targeting and sequencing

With costs for DNA tests rapidly dropping over the last few years, new methods have been opened up to companies to sequence human genomes. Public health services have also been able to use them to detect the emergence of novel pathogens, such as the H1N1 virus, but they have been unable to make the technology a part of routine care and treatment.

However Pathogenica hopes to change this, with plans to combine cheaper sequencing with new approaches to isolate specific pieces of the genome, namely the genes that allow an organism to infect its host and cause harm.

Today, physicians diagnose an infection by collecting a sample from a patient, growing the pathogens, and then identifying them by their appearance or the conditions under which they grow. But this approach is time-consuming and only works for a fraction of microbes.

"[Sequencing] allows the diagnostician the possibility of casting a very wide net and even to detect unsuspected dual or triple infections," says Ruben Donis, chief of the molecular genetics branch at the Centers for Disease Control and Prevention, speaking to TechnologyReview.com

"The majority require days to get a result, which is frequently too late," says Ian Lipkin, an infectious-disease specialist at Columbia University. Lipkin is a member of Pathogenica's advisory board. Faster detection would help physicians distinguish between different infections that have similar symptoms but require different treatments, such as viral and bacterial meningitis.

A growing number of pathogens can be detected using so-called molecular tests, developed over the last decade, which identify microbes by isolating and amplifying specific chunks of DNA. Molecular testing is much faster than culture methods, and has improved medical care by letting doctors correctly diagnose a disease and begin treatment before a patient even leaves the doctor's office, says Lipkin. "But directly sequencing DNA is much more precise," he says. Sequencing also lets scientists search for multiple microbes simultaneously.

If the technology is approved, then it could stop the spread of infectious diseases in their tracks before they spread to full blown pandemics.

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