“One sometimes finds what one is not looking for.”
Innovation at bioMérieux
The field of diagnostics has changed considerably over the last few decades, with the emergence of new technologies to support, supplement and occasionally replace traditional microbiology testing. Such technologies are giving healthcare providers access to more timely, informative and accurate results, thereby helping to improve disease management and patient outcomes.
Since its creation, bioMérieux has been investing in R&D which represents approximately 13% its revenues. Its teams are working to develop innovative diagnostic tests to maintain this standard of excellence and provide solutions to address public health challenges such as antimicrobial resistance. They pursue two priority objectives:
- increasing the medical value of diagnostics with tests that support physicians’ decision making by identifying and characterizing disease agents with greater precision;
- providing faster, more reliable and actionable results to improve health outcomes for patients and to protect consumer safety.
bioMérieux’s experience and expertise as a recognized leader in the domain of microbiology places the Company at the forefront of innovation in this field. Specifically in the fight against antibiotic resistance, our Research and Development (R&D) teams are strongly focused on developing more rapid, accurate and informative tests, with high medical value which meet the needs of healthcare professionals and improve patient management.
R&D projects focus on enhancing current bioMérieux platforms and tests, as well as developing innovative approaches that span the entire diagnostic spectrum, from the most highly advanced technologies, to low-cost easily accessible tests for use in low-resource developing nations.
Our R&D teams are also working to further advance the speed and performance of our existing platforms.
One such project is the new technology being developed for the VITEK® 2 Identification and Susceptibility System. Research teams are working to extend the existing menu of VITEK® 2 cards, and in particular, to enhance the detection of resistance to carbapenems mediated by enzymes or other mechanisms. Carbapenems are some of the last-line antibiotics today to treat multi-drug resistant infections. In other work, through the use of new technologies such as enhanced optical imaging, antibiotic susceptibility results may be accelerated to provide highly accurate results within a few hours.
These state-of-the-art and innovative enhancements will deliver additional medically relevant information, increased accuracy of results and the availability of same-day test reports, helping to fight antibiotic resistance by guiding targeted antibiotic treatment to patients earlier and more efficiently.
Speeding up and enhancing diagnostics
The viability of E. coli can be determined by fluorescent labeling.
Photo credit : Quentin Josso, bioMérieux
The revolution of genotyping platforms
The epidemiological monitoring of bacterial, viral, parasitic and fungal infections is being transformed by next-generation genotyping platforms which produce detailed knowledge of nucleic acid (DNA, RNA) sequences, thereby allowing highly accurate profiling of strains. This technology enables public health and hospital microbiology laboratories to potentially identify the cause of an infection, and to track, prevent and contain the spread of the disease agent. Next-generation sequencing (NGS) and whole-genome sequencing (WGS) have become powerful tools in the fight against infectious diseases.
Next Generation Sequencing is poised to become a central tool in the fight against resistance by:
- accurately tracking and controlling pathogen transmission pathways;
- establishing pathogen sequencing as a single data source for microbial identification and predicting antimicrobial resistance;
- helping to diagnose occult infections from non-cultivable organisms, thereby promoting targeted antimicrobial use and reducing the prescription of broad-spectrum antibiotics;
- characterizing the human “microbiome” in order to investigate its precise roles in human health and disease.
Automation, connectivity and “Big data”
Today, laboratory automation and information technologies are driving a new era of “fast microbiology”, with inter-connectivity and generation of billions of pieces of information.
Continuous efforts to improve microbiological diagnostic devices have enabled the automation of many common laboratory procedures, leading to spectacular improvements in the speed of sample testing and results delivery. Tools readily available today can detect pathogens far faster than traditional culture-based methods, generating improved lab efficiency and considerably reducing time to results.
Another key development is in the area of informatics – both in terms of connectivity and “big data” management. Connectivity has been dramatically improved between individual diagnostic systems, and between those systems and the Laboratory Information System (LIS). Connectivity between labs and clinicians has also been revolutionized by linking the LIS with portable “smart” devices. All of these connections can accelerate and facilitate clinicians’ access to the most relevant information, in order to optimize patient care.
The production of billions of pieces of diagnostic-related data, from these machines, labs and connections, offers the potential to perform far more in-depth analyses than has previously been possible. Such analyses can lead to better disease risk prediction, improved patient selection for personalized medicine, and improved evidence-based guidelines for optimal diagnostic testing. In the field of antibiotic resistance, diagnostic inter-connectivity is crucial for providing rapid results to clinicians in order to optimize the choice of antibiotics and therapies in the most timely manner. “Big data” analyses have allowed us to determine which diagnostics are most useful for the detection of certain pathogens, and which patients are most likely to benefit from preventive measures, as just a few examples.
bioMérieux and Lumed: helping hospitals manage the use of antibiotics
bioMérieux and Lumed, a leading edge software firm specialized in healthcare, have signed a partnership for the distribution of the APSS (Antimicrobial Prescription Surveillance System) and DATA software suites designed by Lumed. Drawing on data imported from each patient’s electronic health record, the APSS is a computerized clinical decision-support system designed to assist antimicrobial stewardship teams to monitor clinical information, as soon as information becomes available, and verify that the ongoing treatment remains appropriate. In a recently published study (ref.99), the implementation of the APSS software in the Sherbrooke University Hospital in Canada has demonstrated a sustained reduction of 20% of antimicrobial use.
This agreement adds a valuable new tool to bioMérieux’s line-up of solutions dedicated to antimicrobial resistance.
Besides supporting direct care of patients, diagnostic tests can also be used to characterize and monitor infectious agents, resistance trends and transmission episodes, in the form of surveillance systems which can help limit the further emergence and spread of resistant bacteria.
For example, bioMérieux and Lumed have partnered on an Antimicrobial Prescription Surveillance System to help clinicians monitor clinical data and verify that the ongoing treatment remains appropriate.
Antibiotic resistance is the ability of bacteria to resist the effects of an antibiotic that was once able to treat infections caused by those bacteria. is the ability of bacteria to resist the effects of an antibiotic that was once able to treat infections caused by those bacteria. surveillance systems generate essential information and are a valuable tool for governments, hospital stewardship programs and healthcare systems in general. This information is also used to measure and anticipate resistance trends, in order to assist research and development efforts in the creation of new antibiotics and diagnostics. As well, the spatial and temporal evolution of an infectious agent, along with its pattern of resistance to antibiotics, determines the public health measures to be taken in order to avoid dangerous outbreaks.
Several countries have set up surveillance programs, which vary widely in their scope (healthy animals, diseased animals, food, healthy humans, sick humans), and in their focus (Staphylococcus aureus, Clostridiodes difficile is the main infectious cause of healthcare-associated diarrhea, and can lead to extremely serious and incapacitating pseudomembranous colitis. Due to its oral-fecal route of transmission and the persistence of spores on inert surfaces, C. difficile is highly contagious and requires drastic measures involving patient isolation, hygiene and disinfection., Salmonella belong to the Salmonella genus of Enterobacteriaceae. They cause two types of illness: food-borne gastroenteritis (salmonellosis), and typhoid/paratyphoid fevers. belong to the Salmonella belong to the Salmonella genus of Enterobacteriaceae. They cause two types of illness: food-borne gastroenteritis (salmonellosis), and typhoid/paratyphoid fevers. genus of Enterobacteriaceae. They cause two types of illness: food-borne gastroenteritis (salmonellosis), and typhoid/paratyphoid fevers., Campylobacter, Escherichia coli, Enterococcus, animal pathogens, etc.). The UK boasts a successful example of such a surveillance system, which contributed to understanding and curbing MRSA and C. difficile infections in hospitals. Johnson AP, Davies J, Guy R, et al. Mandatory surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in England: the first 10 years. J Antimicrob Chemother 2012;67:802-09.
Many countries have not yet set up such monitoring programs, especially in low-resource settings. A global network based on harmonized surveillance protocols is taking shape through the deployment of WHO’s Global Antimicrobial Resistance Surveillance System. (http://www.who.int/drugresistance/surveillance/glass-enrolment/en/)