Rapid Fluorescence-based Detection of Bacteria using Quantum Optics

The majority of the 147,000 sepsis cases seen by the NHS annually, are caused by bacterial infections. There is a pressing need for rapid tools for detecting and identifying bacteria in patient samples. Of the £830 M in sepsis treatment costs paid by the NHS and the USD $20 billion by American hospitals, 25% can be saved by reducing time to diagnosis.
In this project, we aim to deliver a novel quantum optics inspired (QPS) device which detects bacteria labelled with new fluorescent carbon nanomaterials in patient samples within 5 mins or less. This system aims to detect the actual cause (bacteria) of the infection as opposed to bio-markers targeted by other Point of Care devices. Our approach will enable the appropriate prescription of anti-biotics and therefore limit the abuse of broad spectrum agents.
This project will place FluoretiQ and University of Bristol in a strong position to attract the follow-on support necessary to commercialise the combined technology diagnostic solution. It also provides FluoretiQ the opportunity to leverage its QPS system to service a new application which would otherwise not be possible with current resources.
Keywords: Rapid Detection of Bacteria, Sepsis, Bacteria Sensor

This proposal seeks support to develop an ultra-sensitive fluorescence detection device that, coupled with the use of novel carbon dot chemistry as probes to label bacteria, is able to detect bacteria in clinical samples and thus form the basis of a rapid point of care test for the presence of bacteria and provide clinicians with early warning of conditions such as sepsis.

Achieving these aims, and developing this technology into a viable point of care detection device, will provide public health, economic and societal benefits to a variety of stakeholders at regional, national and international levels.
Public health benefits will accrue from a reduction in the impact of bacterial infections resulting from the ability to detect the presence of bacteria more rapidly than is the case with present methodologies, that generally require culturing steps before identification can be attempted. Early and appropriate antibiotic administration is key to a successful outcome for sepsis patients; our device will contribute to reducing mortality rates (currently close to 30 %, equating to 44 000 deaths annually
in the UK) in these individuals by providing early identification of infection and the requirement for antibiotic treatment. In the longer term improved detection of bacterial infections, particularly in the primary care setting, will improve patient care for a range of conditions by identifying cases in which antibiotics should be used. This will further benefit public health by reducing unnecessary antibiotic prescribing, which has been linked to antibiotic resistance. Slowing the rate at which resistance emerges will improve treatment outcomes for patients with a wide variety of bacterial infections by prolonging the clinically effective lifetimes of the most useful and cost-effective drugs. This will reduce the numbers of infections that require either more expensive second-line treatments and/or fail to respond to therapy and thus generate complications and require additional interventions which increase the burden upon the NHS.

Economic benefit will result from the positive impact of activities around device design, manufacture and marketing; and more widely from the reduction in the economic burden of bacterial infections. A successful outcome to this project will be a functioning prototype device able to demonstrate proof-of-concept that the combination of sensor and labelling technologies can detect bacteria in samples representative of clinical specimens (e.g. blood or urine samples) with the requisite sensitivity, along with engagement of relevant partners (clinical end users and investors) needed to take the project forward. In the short term, this will enable the industrial partner (FluoretiQ) to expand their operations and create additional skilled jobs associated with refining the device and validating its effectiveness in the clinical laboratory; in the
medium term this will create further jobs associated with manufacture, sales and marketing. While the total cost of bacterial infections to the UK economy is difficult to calculate, sepsis alone is estimated to cost c. £7.5 bn per annum; reducing this figure can be expected to have substantial economic impact.
A reduction in incidence of bacterial infections achieved by successful introduction of point of care tests for conditions such as sepsis would also carry significant societal benefits. For example, patients recovering from sepsis experience complications, manifest in both physical and emotional symptoms, that may extend two years beyond discharge from hospital, require additional support to be managed and impact upon their ability to contribute socially and/or economically.
Reducing the numbers of such infections will thus reduce their impact upon the lives of patients' families and social and professional circles, as well as upon the patients themselves.