What we study: Our work developing specific treatments for infections described above is bounded by the understanding that the treatments are only effective when applied to the appropriate diagnosis. Therefore, we have leveraged our expertise in bacterial detection (used to evaluate antimicrobial performance of our treatments) to design and develop diagnostic assays. Recently, in conjunction with our work looking at biofilm interaction with human blood proteins, we have begun to consider technologies that evaluate host response as well as offending pathogen.

 

Why it matters: First, administration of appropriate antibiotics is the key to reducing morbidity and mortality in sepsis. However, blood cultures – the current standard of care for diagnosis, pathogen identification and antibiotic susceptibility testing – are limited by long time to result (>48hrs) and  low sensitivity and specificity. In almost all cases, patients are started on empiric antibiotics design to cover most but not all of the most likely pathogens. This one-size-fits-all use of antibacterial drugs leads to antibiotic resistance, severe side effects or under-treatment of critically ill patients. Second, the clinical syndrome of sepsis is extraordinarily complex and heterogeneous—at times involving nearly every organ system. There is profound variability in physiologic and laboratory variables among patients and pathogens. This complicates development of personalized treatments and motivates the development of phenotyping assays.

 

Our key contributions: We have developed multiple approaches to detect bacteria without the need for culture. Most impactful is a electro-immune technique that we have shown to detect single digit cells per ml without culture and antibiotic susceptibility testing in less than 4 hours. We maintain an ongoing biorepository of samples from patients presenting to the emergency department with suspected systemic infection. This biorepository is a valuable resource that is being used to evaluate novel diagnostics from half a dozen different investigators, presently.