Sysmex Astrego rapid testing system wins Longitude Prize on AMR

19 Jun 2024

Assessing antimicrobial effect through phase-contrast imaging will help meet critical global need.

Healthy benefits: UTI testing

The award and its £8 million prize fund was conferred by Challenge Works, part of Nesta, a UK innovation agency focused on work of public benefit. The Longitude Prize on AMR was created in 2014, although the roots of the Longitude Prize itself go back to 1714.

Sysmex Astrego was awarded the prize for its PA-100 AST system, an automated analyzer targeted in particular at the testing of urinary tract infections (UTI). These are one of the most common bacterial infections and also one of the driving causes of antibiotic prescription worldwide.

"It's impossible to overstate how critical it is to address AMR," commented Nesta. "By 2050 it is predicted to cause 10 million deaths a year, matching those caused by cancer, and cost $1 trillion in additional health costs."

The Sysmex Astrego platform is designed to provide accurate antibiotic susceptibility results in 45 minutes, compared to the 2 to 3 days wait patients currently face. It can initially identify the presence of a bacterial infection in just 15 minutes, and will enable the return of previously "retired" first-line antibiotics, according to the developers.

"The goal is to replace the days of lab test process that doctors and patients must currently endure, and end 'just in case' prescribing that is prevalent as a result, which promotes the development of antibiotic resistance," said Sysmex Astrego.

Real-time monitoring of antibiotic effect

The testing principle employed was developed at Uppsala University in 2017, based around use of a custom-designed microfluidic chip and the monitoring of bacteria individual growth rates. This bespoke analysis chip contained two rows of 2,000 cell traps, with time-lapse phase-contrast microscopy used to follow cell growth rates during antimicrobial treatment.

With this approach "it is possible to determine if a urinary tract infection is caused by resistant bacteria within 30 minutes of loading a urine sample, even if the bacterial concentration in the urine is very low," commented the Uppsala team in its original announcement.

"The same principles would work for sepsis, mastitis, or meningitis. Independent of the sample, the key principle will be true: it is sufficient to measure the single-cell growth of a few hundred bacteria to get very close to the theoretical time limit for monitoring the response to an antibiotic in real time."

The Sysmex Astrego implementation for UTI testing has optimized the procedure further and is designed to be as simple as possible to operate, facilitating translation into clinical use. The current commercial platform tests for five bacterial species and assesses the effects of five different antibiotics, using the same phase-contrast imaging approach.

"The Longitude Prize on AMR will serve as a catalyst for Sysmex to further accelerate its efforts in expanding the global market and its application coverage of the PA-100 AST System, which is set to revolutionize conventional clinical workflows for infectious diseases," commented the company.

"Through this testing system, Sysmex will continue its contribution to tackling the universal threat of AMR."