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  F E A T U R E S  
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FEATURES
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NIH FUNDS NEW POINT-OF-CARE TESTING FOR USE AT DISASTERS

 "" PHOTO — UC Davis' Dr. Richard Louie, a fellow at the UC Davis-Lawrence Livermore National Laboratory Center for Point-of-Care Technologies, operates a POC device.
 
UC Davis' Dr. Richard Louie, a fellow at the UC Davis-Lawrence Livermore National Laboratory Center for Point-of-Care Technologies, operates a POC device.
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Doctors one day may be able to diagnose bloodstream infections within one hour rather than waiting a day to several days for conventional test results from labs. And, instead of transporting a blood sample to a hospital, doctors may well have the capability to render a diagnosis at an emergency shelter or at the scene of a disaster.

These and other advances are the expected results from a fiveyear, $8.5 million grant awarded recently to UC Davis Health System and Lawrence Livermore National Laboratory that will focus on pointof- care testing (POCT). POCT is defined as diagnostic testing at or near the site of patient care.

The National Institute of Biomedical Imaging and Bioengineering grant funds two prototype instruments that simultaneously detect five bacterial and fungal pathogens. It also funds evaluations of other exploratory diagnostic technologies intended to prepare the nation for future disasters.

"The goal is to improve the accessibility, portability and field robustness of POC instruments for critical-emergency-disaster care in community hospitals, rural areas and disaster response sites," says Gerald Kost, UC Davis professor of Pathology and Laboratory Medicine and director of the POCT center.

Events during Hurricane Katrina demonstrated the basic feasibility of POCT, but follow-up laboratory experiments showed that current equipment is not adequate for field use, says Kost, the grant's principal investigator.

The five pathogens for which unique identification signatures will be developed under the grant are:

  • Methicillin-resistant Staphylococcus aureus (MRSA)
    is a bacterium associated with catheter-related line infections, and skin and soft tissue infections. MRSA also appears in community settings, such as schools.
  • Pseudomonas aeruginosais a bacterium often linked to hospital-acquired bloodstream infections and associated with pulmonary complications, such as respiratory distress syndrome. People whose wounds have been contaminated with fresh water or water-soil mixtures are more likely to contract infections from this bacterium.
  • Escherichia coli is one of the more common organisms found among patients who develop hospital-acquired infections. This pathogen also is the most frequent community-acquired bacterium in urinary tract infections and occasionally shows up in food products, such as contaminated ground beef and salad greens.
  • Streptococcus pneumoniae is the most common cause of severe community-acquired pneumonia.
  • Candida yeast infections affect people with weakened immune systems.
PHOTO — An artist's concept of the portable testing equipment for which NIH is funding development. The equipment is designed to be used at the scene of a disaster to more quickly diagnose and contain any potential disease outbreaks.  ""

An artist's concept of the portable testing equipment for which NIH is funding development. The equipment is designed to be used at the scene of a disaster to more quickly diagnose and contain any potential disease outbreaks.
 
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"These five pathogens were selected based on their clinical significance, occurrence in hospitalized patients, threat to the community, and frequency of being isolated from the wounds of victims of severe weather- and flood-related natural disasters," Kost says.

Initially, using a blood sample from one person, the new instruments will run a simultaneous test for all five pathogens within one hour. Eventually, the team hopes to outfit the instruments with the capability to run tests for all five pathogens within an hour for several people at the same time.

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