Metagenome-based rapid diagnostics for urinary tract infections could reduce antibiotic consumption
Research team develops fast, accurate, and cost-effective method for analyzing disease-causing bacteria and their antibiotic sensitivity
Nanopore DNA sequencing of a patient sample.
Urinary tract infections are among the most common reasons for prescribing antibiotics. Since conventional pathogen identification in the laboratory usually takes two to three days, initial treatment is often with broad-spectrum antibiotics. However, this non-specific use promotes the development of multi-resistant germs, against which conventional drugs are increasingly ineffective. An international team of researchers from Justus Liebig University Giessen (JLU), the German Center for Infection Research (DZIF), Inland University Norway, the University of Oslo (Norway), and Aarhus University (Denmark) has now developed an innovative, cost-effective, and precise method for obtaining diagnostic information from patient samples within a very short time. The results have been published in the renowned journal Nature Communications.
Every year, around 405 million people worldwide are affected by urinary tract infections. Doctors currently use bacterial cultures to detect infections. This process usually takes two to four days or even longer to obtain results. The new method works without the need for time-consuming bacterial cultures: the researchers have combined direct sequencing of the entire DNA material in patient samples with real-time data analysis. “This so-called metagenomic sequencing enables precise pathogen and antibiotic resistance profiling for complicated urinary tract infections in about four hours,” explains PD Dr. Torsten Hain, acting head (research and teaching) of the Institute of Medical Microbiology at JLU. “The method is also extremely reliable: it detects the disease-causing bacterium in 99 percent of cases.”
PD Dr. Can Imirzalioglu, acting head (diagnostics/clinical microbiology) of the Institute of Medical Microbiology at JLU, says: "The common practice is to use large amounts of broad-spectrum antibiotics while doctors wait for the results of laboratory diagnostic confirmation of the pathogen and its sensitivity. We can prove that our method can replace this practice and has several advantages: It means better treatment for patients by optimizing the use of antibiotics and avoiding unnecessary treatments. Last but not least, it reduces the risk of resistance developing."
The new method can predict with 90 percent accuracy which antibiotic the respective pathogens are sensitive to – i.e., which antibiotic will be effective. This is of great importance because antibiotic resistance is increasing worldwide and endangering an important tool of modern medicine. The reduced and targeted use of antibiotics is therefore essential.
The study also shows that the new method can be up to 30 percent more cost-effective than the alternatives. “Cost-effectiveness is very important when introducing new technologies,” emphasizes Prof. Dr. Florian Wagenlehner, Director of the Clinic for Urology, Pediatric Urology, and Andrology at JLU and the University Hospital of Giessen and Marburg (UKGM) in Giessen. “Our method is an affordable solution for hospitals and clinics. In addition, it can save costs by reducing the length of hospital stays.”
