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Over 25 million people are diagnosed each year with bacterial infections in the western world, posing a major burden for healthcare systems worldwide, which is estimated to exceed € 30 billion each year in the Western world alone. In part, this economic burden is caused by a lack of solutions that can deliver accurate and comprehensive diagnostic information in time.
Successful treatment of bacterial infections has the potential to save millions of lives – and millions of € – each year. The most important step is selecting the appropriate medicine as early as possible. However to date, the lack of diagnostic tools leads to treatment decisions based on observations and experience - empiric antibiosis. As an example, according to a study, inadequate treatment schemes are applied in as many as about 40% of ventilator-associated pneumonia cases. Often, this may result in a more complicated and expensive therapy and worse prognosis. Inappropriate initial treatment also contributes to the spread of antibiotic resistances – e.g. when broad-spectrum rather than targeted antibiotics are used.
Pneumonia is a high-incidence, acute infection. It can result from various causes, in adults most commonly bacterial infections.
Apart from community-acquired pneumonias which in 20 % need hospitalization, up to 5% of patients admitted to a hospital for other causes develop a pneumonia. A hospitalized pneumonia is a fast progressing disease with mortality rates up to 36% and an average hospital stay of 11 to 14 days. Adequate initial treatment can significantly reduce both mortality and the length of hospital stays: For ventilator-associated pneumonia (VAP), early treatment reduces mortality from 36 % to 16%, shortens the length of stay in the intensive care unit by 3 days, and saves on average more than € 5,000 (US$ 7,000) for each patient.
Fast detection of the pneumonia-causing bacteria and potential resistances are a prerequisite for appropriate patient treatment. Unfortunately, these tools are still missing today.
Surgical Site Infections (SSIs) are a real risk and represent a significant burden in terms of patient morbidity and mortality, and cost to health services around the world. Infections after surgery are one of the most common forms of nosocomial infections, accounting for approximately 25% of hospital-acquired infections. The estimated incidence in the US is 700,000 up to 1 Mio depending on sources. CDC states about 2.6% of the 27 million in-patient surgeries annually are associated with infectious complications, in about 15% of cases severe ones. These patients are twice as likely to die. 60% of those spend a longer period of time in an ICU and are more than five times as likely to be readmitted to the hospital.
Key to improve medical outcome is the early identification of the causing pathogen followed by an adequate antimicrobial regimen.
Sepsis kills 1,400 people every day worldwide. In 2007, septicemia was recorded as the 10th leading cause of death in the US with as many as 750,000 to 900,000 cases, resulting in around 200,000 deaths. The incidence of sepsis continues to rise, with an increase of 1.5% per annum. Mortality rates range from 20% for sepsis to 40% for severe sepsis to >60% for septic shock and accounts for 25% of ICU bed utilization. Mean LOS of 8.9 days drives the high economic burden (€ 17,000- € 53,000 per patient). The incidence in the European Union has been estimated at 90.4 cases per 100,000 population, as opposed to 58/100,000 for breast cancer. It has been estimated in European studies that a typical episode of severe sepsis costs a healthcare organization approximately € 25,000.
Sepsis is very difficult to diagnose early and only in about 50% of the cases the causing organism can be identified by classical microbiology. The lack of diagnostic information and the associated nature of empiric treatment have severe implications for patient prognosis, cost of therapy and the development of resistant strains. Studies have shown that correct initial therapy significantly influences clinical outcomes and inadequate antimicrobial therapy is associated with mortality rates up to 62%.
Due to the increasing prevalence of antibiotic-resistant pathogen strains, tuberculosis is becoming an increasingly difficult to treat disease. In 2009, the World Health Organization (WHO) estimated there were 9.3 million new cases of tuberculosis and 1.3 million tuberculosis deaths, making tuberculosis the world’s second deadliest infectious disease after AIDS.
Today, around 10% of patients are even assumed to be suffering from a highly resistant form of tuberculosis (MDR-TB, or multidrug-resistant TB). New MDR-TB cases are currently estimated at about 500,000 a year. Treatment for MDR-TB is much more difficult, and produces lower success rates than treatment for drug-sensitive forms of tuberculosis. Therapy takes 12 to 24 months and requires medication that can cost US$ 180,000 for each patient. Therefore, the control of drug-resistant tuberculosis by fast detection of multi-resistant TB strains with ease-of-use, affordable diagnostic tool is very important.
© Curetis AG 2013