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New project to improve diagnosis of bacterial infections in children

10th June 2016

An international team of doctors and scientists are aiming to develop a rapid test to allow medics to quickly identify bacterial infection in children.

The hope is the £14m project, which involves Newcastle University, will not only allow medical staff to reduce the number of unnecessary antibiotics but it could also quickly identify deadly cases of meningitis, sepsis and other life-threatening bacterial infections.

In the new project, called PERFORM (Personalised Risk assessment in febrile illness to Optimise Real-life Management across the European Union), the team will build on previous research that showed bacterial illnesses can be identified by a particular patterns of genes and proteins.

Early targeted therapy

Experts at Newcastle University and the Great North Children’s Hospital are involved in this collaborative effort to better understand and diagnose childhood infections, aiming for early targeted therapy.

Dr Marieke Emonts, honorary clinical senior lecturer at Newcastle University and consultant paediatric Infectious Diseases, will lead patient recruitment with an additional focus on the immunocompromised in Newcastle.

She said: “The Newcastle team is proud to be part of this collaborative project to better understand and diagnose childhood infections. It shows that we are helping to lead the way in this important field.

“About 25% of children presenting at our A&E departments do so for fever. Distinguishing mild viral infections from early stages of potentially severe and life-threatening bacterial infections is challenging.

“This is an interdisciplinary project that will link state-of the-art bio analyses and clinical markers to aid in early identification of the cause of the fever; viral, bacterial or inflammatory.”

The study comes under the umbrella of Newcastle Academic Health Partners as it is a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University.

PERFORM project

PERFORM is funded by the European Union’s H2020 programme and involves 18 partner institutions in 10 countries.

The team will build on previous research that showed bacterial illnesses can be identified by a particular patterns of genes and proteins.

Mike Levin, Professor of International Child Health at Imperial College London, who leads the new project said: “Rather than attempting to identify the bacteria, which has been the focus of most previous tests for bacterial infection, we believe bacterial infection can be recognised by the pattern of genes and proteins activated by the child’s immune system in response to the infection.”

Study involves children in Europe and West Africa

During the five-year project the team will study around 60,000 children across Europe and West Africa who arrive at hospitals and clinics with a high fever.

At the moment, when a child arrives at a surgery or hospital with fever, doctors have no quick method of distinguishing whether the child is suffering from bacterial or viral illness. Diagnosis relies instead on taking a sample of blood or spinal fluid, and seeing if bacteria grow in this sample. However, this can take more than 48 hours.

Differentiating between viruses and bacteria is crucially important. Although viral infections are much more common than bacterial infections, the latter are far more dangerous, and lead to a deadly conditions such as meningitis, septicaemia and pneumonia.

Because of the fear of “missing” bacterial infection, doctors often give antibiotics immediately to children with high fever before the test results are available to confirm whether the child is suffering from a bacterial or viral infection.

Professor Levin added: “Fever is one of the most common reasons children are brought to medical care. While most episodes of high fever in children are due to a viral illness – which will often get better on its own –  hidden amongst them are life-threatening bacterial infections. Our current methods do not allow doctors to reliably distinguish between life-threatening bacterial infection and trivial viral illness.

“As a result, thousands of children each day worldwide undergo investigations such as lumbar puncture, x-rays and blood tests and are treated with antibiotics while awaiting the results of investigations to rule out bacterial infection.”

Antibiotic resistance

Antibiotics are powerless against viral infections. The frequent unnecessary use of antibiotics to treat children with common viral infections, contributes to the growing threat of antibiotic resistance, which a recent Government report warned would kill one person every three seconds by 2050.

Professor Levin added: “Lack of an accurate, reliable and rapid test to distinguish bacterial infections from the vastly more common viral infections is a major factor leading to widespread prescription of antibiotics in both hospitals and in the community. Indeed, the Government’s O’Neill report recently highlighted the urgent need for the development of these rapid tests.”

The PERFORM international team includes groups from Newcastle, Oxford, Liverpool, Spain, Austria, Germany, The Netherlands, Greece, Slovenia, Latvia , the Gambia and Switzerland, as well as the biotechnology companies Micropathology Ltd UK and bioMérieux, France.

Press release adapted with thanks to Imperial College London