Posts Tagged diabetes
Speedy identification of pathogens: saves lives, reduces cost & lowers antibiotic resistance problem
Posted by Darshana V. Nadkarni, Ph.D. in Biotech - Medical Device - Life Science - Healthcare on September 24, 2019
At a recent Bio2DeviceGroup (www.bio2devicegroup.org) event, Kevin Hacker, CEO of BioAffinity Sciences talked about their new technology that when fully developed will identify pathogens more than 100 times faster than the traditional blood culture and related technologies currently in use.
Every year, in the US, 500 thousand people die due to sepsis related complications. Sepsis is a final common pathway for many infections, particularly when an individual’s immunity is low. Body normally releases chemicals into the bloodstream to fight an infection. When the body’s response to these chemicals is out of balance, it results in Sepsis. That is when body’s immune system launches a massive counter attack that harms body’s own tissues and organs. The triggering changes begin to damage body’s vital organ systems that results in dramatic drop in the blood pressure, ultimately leading to death.
Sepsis and septic shock are more common if the individual is very young or very old, have a compromised immune system, have diabetes or cirrhosis, is already sick and frequently in a hospital intensive care unit, have wounds or injuries or severe burns, have invasive devices inserted into the body, and have previously received antibiotics or corticosteroids. Often people can recover from mild sepsis. However, if the body goes into septic shock, the average mortality rate for septic shock is about 40%. Additionally, an episode of severe sepsis may place a person at higher risk of future infections.
Given that widespread infections can progress to Sepsis and Sepsis shock in a matter of few hours, it is imperative that such infections be treated immediately with antibiotics. When given the right antibiotics, there is often a dramatic improvement and speed of cure.
Problem with speedy identification of pathogens
Given that early treatment of sepsis is associated with vastly improved outcomes, rapid diagnosis is essential. However blood culture work is slow and often takes 1-3 days. The diagnosis of sepsis in critically ill patients, housed in hospitals is also challenging because it can be complicated by the presence of inflammation resulting from other underlying diseases and from prior use of antibiotics, making cultures negative. Most testing is done through mass spectrometry that gives mass to charge ratio of ions. Since culture-dependent diagnosis of infection is slow, sometimes patients are given antibiotics, before the results of the culture are available. Patients are given broad spectrum antibiotics and 40% are not effective. In such instances, antibiotics are withdrawn after one cycle of treatment, when the cause of the illness is found to be something else and this can lead to antibiotic resistance.
Bioaffinity Sciences solution will be able to identify pathogens within 10 minutes, 430 fold faster than blood culture. This is cell affinity based, low cost technology. Pathogens are run through microchannels comprising of a surface- grafted scaffold of reactive polymer onto which affinity molecules (sugars, aptamers, vancomycin, and methicillin) have been bio-conjugated. High capacity of the channels allows low numbers of microbes to be quickly identified. The unknown pathogen’s pattern of binding to the channels is recorded, and this pattern is compared to a library of known pathogens. When a match is made, the identity of the pathogen is reported. In addition to speed, this is also more sensitive in terms of the number of different pathogens detected than blood culture.
Disease burden to the healthcare system in the US due to Sepsis
Sepsis management is a major challenge and results in disproportionately high burden in terms of hospital utilization. The average length of stay for sepsis patients in the US is approximately 75% greater than for other conditions. The cost of sepsis management ranks highest among hospital admissions for all disease states. The cost is estimated to be between $25 billion and $27 billion, and represents 13% of total US hospital costs.
Considering that poor sepsis outcomes are directly tied to the delay in diagnosis and treatment, such a dramatic improvement in speed and accuracy of diagnosis leading to speedy and accurate treatment can not only dramatically improve outcome and quality of patient care but also significantly reduce cost of care for hospitals.
The talk was followed by Q&A.
Posted by Darshana V. Nadkarni, Ph.D. in Biotech - Medical Device - Life Science - Healthcare on March 13, 2013
Worldwide, medical adherence or patients prematurely stopping their medications, is a major obstacle to the effective delivery of health care. David Parpart and Sunit Gala talked about the complexity of the problem, the enormous cost to the healthcare of non-compliance and the technology-based solutions they are offering (www.impactmeds.com) to improve adherence at a www.bio2devicegroup.org event.
To give a sense of the enormity of the problem, Parpart shared a typical scenario where out of 100% prescriptions, only 50-70% go to the pharmacy, and out of that only 48-66% come out of pharmacy, out which only 25-30% of the medications are taken as prescribed and finally a miniscule 15-20% are refilled as prescribed by the physician. Among new prescriptions for medicines used to treat chronic conditions associated with increased cardiovascular risk, such as hypertension, diabetes, and dyslipidemia, according to some estimates, one-third of all new prescriptions go unfilled. About 350 daily deaths in the US are attributed to lack of medical adherence, said Parpart.
Non-adherence to prescribed medications not only costs huge amount of lost revenue to the pharmaceutical companies and lost sales to the drug stores, but also it also burdens hospitals with readmissions and burdens the payers, in addition to the impact on patients. On account of non adherence, many patients suffer from bad health, and in many cases, particularly those suffering from chronic diseases, die early. Chronic diseases account for 70% of all deaths and are the leading cause of mortality in the United States. Patients who don’t take their medications as prescribed cost the U.S. health care system an estimated $290 billion. Non-compliance costs pharmaceutical companies $300 billion in lost revenues. Added cost to the society is $100 billion in preventable hospital visits and $350 billion in productivity losses. There is a huge opportunity here to reduce costs and improve outcomes. About 1 million unnecessary deaths can be prevented just within the United States this decade, with improved medical adherence, said Parpart.
So what are major barriers to medical adherence? Some of the major barriers include the complexity of medication regimens, especially in case of chronic diseases when the patient is often taking 9 to 12 medications multiple times per day; the occurrence of side effects, which are sometimes unknown to the patients; the cost of prescription medications; and poor communication and lack of trust between the patient and their health care provider. Just providing a planned opportunity for the patient to interact with the pharmacist regarding side effects and the necessity of sticking with the regimen greatly improves compliance according to numerous well-documented studies conducted by organizations such as the American Pharmacists Association.
Parpart and Gala shared the Impact Meds solution to this enormous challenge. They leverage technology with a cloud-based software platform, RFID, and offer an array of solutions that can be tailored and customized, starting with an opportunity for patients and pharmacists to register on their website with easy access for patients to get their questions answered and get pharmacist led counseling. Their solution is a combination of availability of medical information, easy access points for patient-pharmacist interaction, tools for caregivers, medical tracking solutions, tracking biometrics and purchase refills, and scaling it to have maximum impact in terms of lowered medical costs to society and improved health for patients. An important aspect of the solution is how it incentivizes pharmacists, physicians and patients through a combination of respect, regard and reward. Impact Meds is a recipient of 2012 Sanofi US Innovation Challenge Award, as well The Palo Alto Medical Foundation’s Developer Challenge. The presentation was followed by Q&A from an enthusiastic audience, with the event running over-time.