New medical test will prevent deadly overuse of antibiotics
Test determines if illness is either viral or bacterial infection, ceasing over-prescription of antibiotics
The overuse of antibiotics in medicine has led to a strain of drug-resistant illnesses that have left the medical community baffled. It's the result of good intentions on the part of many doctors: A patient comes in with a fever and the doctor prescribes antibiotics just in case. These drugs don't work if a virus is to blame. Now, a new test will let physicians know if the ailment is either viral or a bacterial infection, stopping the overuse of antibiotics.
A negative test for symptoms, i.e. a cough or fever not leading to a common cold diagnosis, can leave the doctor wondering what germ to check for next, or to make a "guess-timate."
The system takes a fingerprint of the patient's immune system and how the genes are fighting the bug. If the experimental test pans out, it promises to help doctors track mysterious new health threats, such as the next flu pandemic or that mysterious MERS virus in the Middle East.
That viral "signature could be quite powerful, and may be a game-changer," said Dr. Geoffrey Ginsburg, Duke's genomic medicine chief. Team leader Ginsburg says that a study involving 102 people has provided evidence that the test can work.
When symptoms aren't enough for diagnosis, a doctor's suspicion guides what tests are performed. These tests search for a specific pathogen. A negative test for symptoms, i.e. a cough or fever not leading to a common cold diagnosis, can leave the doctor wondering what germ to check for next, or to make a "guess-timate."
Tests performed quickly in an office setting aren't always accurate and can miss infections. Patients may have blood or other samples sent to labs to try to grow any lurking bacteria and tell if it's to blame - and this can take days.
"This is something we struggle with every day," Dr. Octavio Ramilo, infectious disease chief at Nationwide Children's Hospital in Columbus, Ohio says. Ramilo wasn't involved in the new study. He says that a respiratory virus and a bacterial infection, especially in children "in the beginning look completely alike," he added.
Researchers at a number of universities are trying to harness a fairly recent discovery: As your immune system detects an invading bug, different genes are activated to fend off a viral infection than to fight a bacterial or fungal one.
These changes occur even before the patient feels any symptoms, forming distinct patterns of RNA and proteins, what's called a genomic fingerprint.
The Duke team discovered 30 genes that are switched on in different ways during a viral attack. The test essentially is a freeze-frame to show "what those genes are doing at the moment in time that it's captured," Duke lead researcher Dr. Aimee Zaas says.
Finally, why is determining that a virus is present - or not, so important? That's enough information to rule out antibiotics, Zaas said. Unnecessary antibiotic use is one factor in the growing problem of drug-resistant germs, which the government blames for more than 23,000 deaths a year.
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