Harald's Interview & Publication
SYNLAB Germany
Harald Hoffmann
What inspired your research and what did it cover?
Tuberculosis (TB) remains the number one killer among infectious diseases worldwide. Rapid diagnosis and early initiation of a fully effective anti-TB treatment are crucial to cure the patient, prevent long-term lung damage, and counteract the development and spread of resistance toward anti-TB drugs.
As a WHO-Supranational TB Reference Laboratory, we are helping nine countries to effectively fight the global TB epidemic (mainly in Eastern Europe and Central Asia – the hotspot regions of multi-drug-resistant [MDR]-TB). We constantly see the tremendous negative impact of anti-TB-drug resistance on individual treatment outcomes (cure-rate <60%), on the public health system and on the state health budget (the total costs of an MDR-TB regimen are >500 x higher than those of a regimen for susceptible TB).
With our project, we aimed to develop a rapid, easy to use point-of-care test that can not only reliably detect the TB pathogen, but also its genetic resistance markers for the most important anti-TB drugs. It shall be combinable with targeted NGS testing for the full spectrum of genetic resistance markers of TB bacteria.
Looking at the potential of your findings, what difference can they make?
Under the leadership of IML Gauting the research consortium developed an industry model of the centrifugal-microfluidic, geometric multiplex TB-PCR assay “TB-SeqDisk” that fulfils all the target specifications.
The architecture of the cartridge is simple, and its production will be possible at a low cost. This means that the assay will be affordable for low-income countries and easy to perform with minimal training and maintenance capacities. It reliably detects TB and identifies MDR at the point of care. The cartridge provides purified DNA in a removable reaction vial, allowing to determine the complete resistome of the bacteria with a down-stream targeted NGS examination. This enables doctors to immediately implement a WHO-endorsed MDR-TB treatment regime, to successfully interrupt further transmission, and to prevent long-term sequels of the disease.
Publication
Two-stage tuberculosis diagnostics: combining centrifugal microfluidics to detect TB infection and Inh and Rif resistance at the point of care with subsequent antibiotic resistance profiling by targeted NGS
National Library of Medicine – https://pubmed.ncbi.nlm.nih.gov/37999937/
Globally, tuberculosis (TB) remains the deadliest bacterial infectious disease, and spreading antibiotic resistances is the biggest challenge for combatting the disease. Rapid and comprehensive diagnostics including drug susceptibility testing (DST) would assure early treatment, reduction of morbidity and the interruption of transmission chains.