Developing a point of care diagnostic device for urinary tract infection (UTI)

D4D is collaborating with scientists, clinicians, patients and businesses to develop a point of care technology to enable more accurate diagnosis of UTIs, and to guide treatment selection.

Project Lead and Organisation

Dr Nicola Morris, Bristol Urological Institute, North Bristol NHS Trust

When did project start?

2014

Clinical Requirement

Urinary tract infection (UTI) is a common occurrence, with women more frequently affected – an estimated 15% of women develop a UTI each year. UTIs are usually treated with antibiotics but can have severe consequences including kidney damage, sepsis or death if inappropriately or inadequately treated. Correct diagnosis of UTI relies on a number of factors including the person’s clinical history and the presence of high numbers of bacteria in the urine, with lab-based confirmation of diagnosis taking around 24 hours. It takes around 48 hours to confirm which antibiotics are likely to be most appropriate. For patients seeing their GP with a suspected UTI, they may be given a course of antibiotics if the doctor suspects a UTI, which may then need to be changed or stopped once the lab results become available.

Not all patients are diagnosed by GPs or specialists. Many patients are inappropriately diagnosed based on dipstick analysis, with their clinical history not taken into account. 40% of unnecessary antibiotic prescriptions are due to inappropriate UTI diagnoses, and a third of these prescriptions cause harm in the patient. Unnecessary analysis of urine samples is also expensive for NHS laboratory diagnostic services.

The Solution

We are testing a novel lab-based technology that has the potential to quickly and accurately measure the amount of bacteria in urine samples, and identify the species, as well as other indicators of problematic (rather than asymptomatic) urine infections. We hope to demonstrate that the technology can perform as required and provide a result in a matter of minutes, and that this is relevant to existing clinical pathways.  If successful we will seek funding to work with carefully selected industry partners to develop the technology as a point-of-care device for trial within clinical practice, at the patient’s bedside or in the GP’s surgery.

Impact

We anticipate that if the technology proves effective it could have wide-reaching impacts on health practice and clinical pathways, especially in primary care. It could lead to reduced use of antibiotics, and reduction of the incidence of harm to patients who may otherwise have been inappropriately prescribed antibiotics. It has the potential to reduce health costs by more accurately diagnosing patients, thereby reducing inappropriate admissions, and reducing test costs.

Partners

  • University of West of England
  • North Bristol NHS Trust
  • D4D at Sheffield Teaching Hospitals NHS Foundation Trust
  • Bladder Health UK
  • Oxford DEC