The study uses a simple finger-prick blood test and throat swab to rapidly identify bacterial infections and their susceptibility to antibiotics. This innovative diagnostic approach helps healthcare providers deliver more precise treatments, reducing the misuse of antibiotics and slowing the development of antibiotic-resistant bacteria.
By integrating this cutting-edge method into clinical protocols, Kardinia Health demonstrates its dedication to advancing medical practices and improving patient outcomes.
The usual test for a bacterial infection can take days to produce a result.
But an Australian-first trial is informing doctors almost instantly, giving them more certainty when prescribing antibiotics.
Five GP clinics in Geelong are using a finger prick or throat swab to test whether a patient’s infection is bacterial or whether it’s caused by a different type of microbe.
Both tests produce a result within a few minutes.
The throat swab detects Strep A bacteria — which causes a sore throat including tonsillitis or pharyngitis — while the finger prick is mostly used to diagnose respiratory tract infections, by detecting bacteria in the bloodstream.
The machine specifies whether a sample is Strep A positive or negative. (ABC News: Natasha Schapova)
Deakin University research fellow Sajal Saha said the tests aimed to reduce antimicrobial resistance — a global health threat — where microorganisms like bacteria do not respond to antibiotics.
Antimicrobial resistance has spawned from the overuse and misuse of antimicrobials, like antibiotics, and contributed to 1.27 million deaths worldwide in 2019, according to the World Health Organization.
Dr Saha said about 50 to 60 per cent of antibiotic prescriptions were unnecessary, with Australia having some of the highest rates in the developed world.
“Our research is trying to address how can I support general practitioners to overcome the diagnostic uncertainty,” he said.
“The global trial demonstrated that this has potential to reduce antibiotic [usage] up to 40 to 60 per cent however, this testing is not available in any clinical settings in Australia.”
Current tests for bacteria take more than a day to produce results. This means that GPs often prescribe antibiotics before receiving those results, which would confirm whether an infection is bacterial and requires antibiotics, or viral and needs alternative treatment.
A nurse demonstrates the finger prick test on a team member at Kardinia Health
“They [normally] order the test through a culture and take the sample, and then it goes to the lab, but the results take 24 to 48 hours to come back,” Dr Saha said.
The finger prick test, also known as a C-reactive protein (CRP) test, has been trialled in healthcare centres overseas, including in Vietnam and England where both trials concluded the test could reduce antibiotic misuse.
The throat swab is a newer technology that is under-explored but neither the throat swab nor the CRP test have been trialled in Australian general practice or pharmacies.
The feasibility trial was completed in Geelong last year — assessing the tests on a smaller scale — with a pilot trial beginning in May.
The pilot trial will be on a larger scale across regional and rural settings and will continue until October, after which researchers will analyse the results.
Dr Saha said the tests were likely to benefit urgent care centres and larger clinics the most, where there is a higher volume of patients.
“This test has enormous benefit to avoid misuse of antibiotics, and we expect it to greatly enhance the diagnostic capacity of rural and regional Victorian GPs in Geelong and another state and even nationally,” he said.
Deakin University professor of infectious diseases Eugene Athan said superbugs and multi-resistant bacteria were becoming increasingly difficult to treat.
Globally, WHO estimates antimicrobial resistance could result in up to 10 million deaths each year by 2050.
“So this will help that process of protecting antibiotics that we need to reserve for the future so that we still have effective drugs going forward,” he said.
Antibiotics are prescribed to treat acute tonsillitis twice as often than they are required, according to the 2023 report on antimicrobial use and resistance in human health.
Professor Athan said many patients expected to be prescribed with antibiotics when seeing a doctor for common conditions like a cold or sore throat.
He said some doctors found it easier to prescribe the drug rather than to reassure a patient.
“So I think we’re trying to change that attitude and reset the conversations with patients to say you don’t always need an antibiotic,” Professor Athan said.
“GPs are the main prescribers of antibiotics in Australia, they make up more than half of all prescribing.
“So I think we have to start at the very point where there’s a lot of prescribing going on and that’s at the primary care level.”
Kardinia Health is one of the clinics in Geelong trialling the tests and one of its GPs, Nic Brayshaw, said it provided him with more confidence when diagnosing patients.
“I think it’ll be reassuring to patients as well to know that there is, in fact, no purpose in them having antibiotics,” he said.
Nic Brayshaw says the tests are likely to be useful in remote Indigenous communities where Strep infections and complications are more prevalent. (ABC News: Natasha Schapova)
But some researchers say although the tests are promising, more research is needed to investigate the accuracy and sensitivity of the technologies in differentiating between bacterial and viral pathogens.
“It is not uncommon for respiratory viral infections in some patients to be followed by a secondary bacterial infection, which needs antibiotics for treatment,” RMIT University Associate Professor in microbiology Taghrid Istivan said.
Dr Istivan said the throat swab that tests for Strep A could allow a throat infection, caused by other types of bacteria, to go unnoticed.
“It only identifies one bacterial group causing such upper respiratory tract infections when there are other bacteria like neisseria and haemophilus that can also cause these kinds of infections,” she said.
“Although it is important to implement these newly developed rapid methods across most of the clinics … more thorough molecular and conventional laboratory methods should not be neglected.”
Australia has developed a coordinated method to minimise the development and spread of antimicrobial resistance, through its antimicrobial resistance strategy.
The national strategy focuses on clear governance for antimicrobial resistance initiatives, the prevention and control of infection and the spread of resistance, integrated surveillance and response to resistance and usage, research collaborations and global partnerships.
Professor Athan said taking action was imperative to ensure antimicrobials could continue to be effective.
“Patients would die if they have a superbug that we no longer have antibiotic options for,” he said.
