A new imaging tool that rapidly diagnoses bacterial lung infections could help prevent unnecessary use of antibiotics in intensive care units (University of Bath, 2017).

The bedside technology can detect whether harmful bacteria are present within sixty seconds, so that patients can be treated with the right medicine quickly.

Experts say accurate diagnosis means unnecessary use of antibiotics can be avoided if an infection is not present, helping to stop the emergence of bacteria that are resistant to the medicines.

Further development of the technology has received £2m from the Wellcome Trust and will receive up to £0.9m ($1.12m) from CARB-X, a major international initiative to tackle antibiotic resistance co-funded by the US Government and Wellcome.

The interdisciplinary collaboration, called Proteus, is led by researchers at the University of Bath, University of Edinburgh and Heriot-Watt University. It has been supported by EPSRC with additional support from the Wellcome Trust and MRC.

Proteus uses chemicals that light up when they attach to specific types of bacterial infection. This fluorescence is detected using fibre-optic tubes that are small enough to be threaded deep inside patients’ lungs. The team says the technology easily reaches parts of the lungs existing tools can’t. It could revolutionise the way critically ill patients, and others with long-term lung conditions, are assessed and treated. It could also aid understanding of bacterial diseases.

Researchers are initially focused on helping patients with lung infections and intensive care patients with suspected pneumonia who are being ventilated to help them breathe.

Around twenty million patients in intensive care need machines to help them breathe each year. Up to one third of these patients are suspected as having serious lung infections during their time in intensive care.

Doctors currently rely on X-rays and blood tests for diagnosis, but these can be slow and imprecise. Patients are often treated with antibiotics as a precaution, which exposes them to potential side effects.

Experts say that a blanket approach to therapy contributes to the emergence of bacteria that are resistant to antibiotics.

Kev Dhaliwal, who is leading the CARB-X supported project and is a Consultant in Respiratory Medicine at the University of Edinburgh, said “We need to understand disease in patients better so that we can make better decisions at the bedside. The Proteus project and clinical partners brings together scientists and clinicians from many disciplines from all corners of the United Kingdom to develop technology that can help us spot disease in real time at the bedside and help us to give the right treatments at the right time. The rise of antimicrobial resistance is the biggest challenge in modern medicine and the support and mentorship from CARB-X will accelerate development of Proteus technology to be ready for clinical use faster and more widely than previously possible.”

Dr Jim Stone, from the University of Bath Department of Physics, said “The Proteus IRC is creating endoscopic sensing and imaging system capable of detecting the presence of harmful bacteria in the lungs. In such an endoscopic system optical fibre technology is a key component delivering and collecting light signals emitted from bacterial chemical probes from the distal lung. In the Centre for Photonics and Photonic Materials we have used our expertise in optical fibre design and fabrication to create optical fibres capable of bacterial imaging, sensing and delivering the chemical probes which form an integral part of the Proteus system.”

Tim Jinks, Head of Drug Resistant Infection at the Wellcome Trust, said “Drug resistant infection is already a huge global health challenge – and it is getting worse. We need global powers to work together on a number of fronts – from the beginning to the end of the drug and diagnostic development pipeline. CARB-X is supporting projects like Proteus to build a robust pipeline of products to fulfil this need.”