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The arms race of bacteria and science.

In the microscopic arms race against bacterial adversaries, antibiotics are our most powerful weapons. But these anti-infectives can lose their effectiveness due to bacterial evolution - Bacteria develop resistance that renders antibiotics ineffective. In this biological competition, the prudent use of antibiotics is just as important as the discovery of new antibiotics. Errors in prescribing antibiotics, whether through overuse or incorrect selection, promote the development of resistance. Without countermeasures, this will inevitably lead to an era in which minor infections can lead to serious outcomes. The key to success in this battle lies in our ability to decide quickly which antibiotics will be effective. A decision that prevents us from giving bacteria an evolutionary advantage. By ensuring that antibiotics are used precisely and sparingly, we defend their continued importance in our medical armoury. A crucial step in keeping the upper hand on the ever-changing microbial world.

Drug resistant bacteria are gaining the upper hand.

Antimicrobial resistance (AMR) is already a significant global killer, with an estimated 1,270,000 deaths annually. If unchecked, this crisis is projected to escalate dramatically, with AMR poised to become a leading cause of mortality worldwide. The urgent challenge before us is to innovate and implement precise diagnostic methods and effective treatments to outpace the rapid emergence of resistant strains and avert a future public health catastrophe.

Drug resistance is driving global health care costs

AMR not only increases healthcare costs due to longer hospital stays and more expensive, less effective treatments, but it also threatens to cripple economies by reducing the workforce through extended illness and premature mortality. The risk of a widespread superbug event — a pandemic of drug-resistant infections — could lead to a catastrophic financial crisis, dwarfing the costs of individual treatment. The long-term economic forecasts warn of a downturn on a scale of the 2008 financial crisis if AMR continues unabated, pointing to an urgent need for investment in innovative diagnostics and new antimicrobial agents.

Current diagnostics fail in precision or speed

While molecular assays deliver fast results within 1-2 h they lack predictive strength. They indicate the presence of a panel of resistance genes, but these genes not always confer resistance in an actual bacterial infection. Even more, genetic testing cannot measure susceptibility to antibiotics. Therefore, in diagnostic routine still phenotypic testing is the standard, where the bacteria are cultured in the presence of a panel of antibiotics. 

More rapid phenotypic methods have been developed in the last years of which some already received IVD approval. These technologies measure relatively slow parameter of bacterial growth. As a result, rapid AST tests still need 4-8h. Pre-culturing of the bacteria, need for most of these tests add further time for overnight incubation. 

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