Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies

Abstract

Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.

Precision epidemiology for infectious disease control

“…To date, the field has primarily focused on the use of patients' own genomic information to make personalized decisions about disease treatment 5 . During infectious disease outbreaks, however, genomic sequence information from the pathogen is arguably more important than an individual's genomic data for designing appropriate treatment and intervention strategies 16 .…”

Integrált optikai szenzor biológiai minták gyors analíziséhez

“…Ez a fő oka annak, hogy egyre több kutatócsoport foglalkozik olyan bioszenzorok fejlesztésével, amelyek megbízhatóan, megfelelő érzékenységgel, rövid idő alatt képesek eredményt szolgáltatni, ugyanakkor előállításuk olcsó és akár orvosi közreműködés nélkül, a beteg otthonában is használhatóak [2]. Jelenleg a legérzékenyebb bioszenzorok többsége jelölésen (például fl uoreszcens, radioaktív vagy mágneses jelölésen) alapul, a jelölőanya-got követve akár egy molekulát is képesek kimutatni a vizsgált térfogatban vagy felületen [3].…”

Integrated optical biosensor for rapid detection of bacteria

“…Note, however, that visual observation by the microscope was used only to control that binding process goes parallelly with the development of the ourput signal, it is not an essential part of our device, whose arrangement supports a full automatic control of the sensing process, from the sample delivery to the detection of the signal. The integrated optical structure combined with microfluidics, on the other hand, grants portability of the device, fulfilling the requirements of state-of-the-art POC diagnostics [8].…”