The role of diagnostic testing in an era of antimicrobial stewardship

As mankind continues its widespread use of antibiotics, antimicrobial resistance will continue to pose a threat to the global healthcare system.

As new antibiotics are developed and used widely around the world, bacteria evolve in parallel, developing resistance and outrunning our ability to treat common infections. Infections caused by antibiotic-resistant bacteria are difficult to treat, killing an estimated 700,000 people a year worldwide.¹

The world learned of the dangers of antimicrobial resistance with the rise of hospital-acquired infections, like methicillin-resistant Staphylococcus aureus (MRSA). Today, there are a growing number of infectious diseases developing resistance to common treatments, including certain respiratory tract infections and sexually transmitted infections. Looking ahead, the prevalence of drug-resistant pathogens is expected to rise.

In the absence of a comprehensive effort to combat emerging drug resistance, infections due to multi-drug resistant organisms are predicted to be the leading cause of death worldwide by 2050.¹

Diagnoses based on signs and symptoms only cannot reliably differentiate bacterial agents, nor discriminate between bacteria, viruses, and fungi.

The inability to accurately diagnose the exact pathogen causing an infection often leads to broad-spectrum or inappropriate antibiotic prescribing. This adds unnecessary cost and promotes the development of antibiotic resistance.² In the U.S., one in three outpatient antibiotic prescriptions are inappropriate.³ Eliminating inappropriate use of antibiotics is essential for preventing the emergence of drug-resistant bacteria, and a key strategy to countering this troubling trend is the consistent and proper use of diagnostic tests.

The traditional “gold-standard” detection technique of culture requires time for the organism to grow—delaying time to result—and needs the skills of a highly trained technician. Today, high-quality molecular testing systems have fast turnaround times and a fully automated workflow to streamline the detection and differentiation of select viral and bacterial agents, including specific determinants of resistance. The efficiency and throughput of these systems present laboratories with an opportunity to elevate, in part, the value they deliver across the healthcare system. Reducing pressure during spikes in demand enables laboratories to inform timely, appropriate clinical management decisions.

To combat an ever-evolving threat of antibiotic resistance, health systems will need to adopt different strategies to cover a range of scenarios.

Recent advances in testing are accelerating the way resistant pathogens are detected compared to traditional methods. Identifying sequences linked to genotypic resistance detection and rapid phenotypic resistance detection enable laboratories to play a greater role in protecting the population from resistant pathogens. However, this is not a battle that will be won in the laboratory alone.

Each year, there are millions of unnecessary antibiotic prescriptions written in doctors’ offices and emergency departments,⁴ highlighting the need for advanced point-of-care (POC) testing solutions. Molecular POC tests are important tools that can bring an accurate diagnosis quickly, enabling the opportunity for faster treatment. Timely and reliable results empower healthcare providers to prescribe more judiciously and employ antibiotic stewardship principles where they can have a notable impact.

As a leader in diagnostics, Roche is committed to providing effective integrated solutions that can inform optimal patient care.

Through continuous monitoring of the global disease landscape, Roche works to identify strategies to combat and control the spread of resistant pathogens. Roche’s innovative technologies allow laboratories to detect drug-resistant bacteria with the speed and simplicity of molecular diagnostics, and provide accurate and actionable results closer to the patient with minimal turnaround times.

Roche is expanding their commitment to antibiotic stewardship through collaboration and innovation—from joining the AMR Action Fund to investing heavily into assays and analyzers that inform effective treatment decisions. Roche tests are trusted to deliver confidence in every result, anywhere, using fully automated high-throughput systems and on-demand testing at the point of care.

As the threat of antimicrobial resistance continues to grow, Roche will be a perennial partner to global health systems, providing world-class solutions to this worldwide challenge.