IUSTI 2019 European Congress

Abstract O-45
A 30-Minute Point of Care test Enabling Immediate Ciprofloxacin Treatment for Neisseria gonorrhoeae

Information about abstract submitter

1) S Tariq Sadiq*, St. George's, University of London, United Kingdom
2) Anna Dixon, Binx Health Limited, United Kingdom
3) Martina Furegato, St. George's, University of London, United Kingdom
4) Emma Harding-Esch, St. George's, University of London, United Kingdom
5) Victoria Hall, Binx Health Limited, United Kingdom
6) Claire Broad, St. George's, University of London, United Kingdom
7) Tom Edwards, Binx Health Limited, United Kingdom
8) Laura Phillips, St. George's, University of London, United Kingdom
9) Liqing Zhou, St. George's, University of London, United Kingdom
10) Sebastian Fuller, St. George's, University of London, United Kingdom
11) John Clarkson, Binx Health Limited, United Kingdom

The main content of abstract
Track
Bacterially Sexually Transmitted Infections
Type of abstract
oral abstract
Objective
Despite widespread antimicrobial resistance (AMR), most Neisseria gonorrhoeae (NG) infections remain susceptible to many antibiotic classes. Absence of NG quinolone resistance determining region mutations (QRDRM) accurately predicts ciprofloxacin (Cp) susceptibility. Point-of-care (POC) AMR testing may permit confident use of Cp therapy while potentially reducing selection pressure on first-line treatments. We developed a 30-minute rapid integrated POC-AMR cartridge to predict Cp susceptibility and performed a preliminary performance evaluation.
Methods
A novel molecular assay, that targets two diagnostic NG markers and NG-specific QRDRM, was optimised and integrated onto the binx® io POC DNA extraction, amplification and electrochemical detection platform. Fully integrated prototype POC-AMR cartridges were evaluated blind for NG diagnostic accuracy as well as for detecting QRDRMs, using all NG-positive and a subset of NG-negative urine and extragenital samples collected from symptomatic men-who-have sex-with-men (MSM) attending four London sexual health clinics, against composite diagnostic and sequencing gold standards.
Results
In urine, pharyngeal and rectal samples, NG Cp-AMR prevalence was 38.1%, 50%, 42.9%, respectively. For the NG POC-AMR: diagnostic sensitivity and specificity were 22/23 (95.6%[95%CI:78.0-99.9]) and 49/49 (100%[92.7-100]), 25/26 (96.1%[80.4- 99.9]) and 72/80 (90.0%[81.2-95.6]), 24/24 (100%[85.7-100]) and 47/51 (92.2%[81.1-97.8]); QRDRM sensitivity and specificity were 8/8 (100%[63.1-100]) and 9/13 (69.2%[38.6-90.9]), 8/9 (88.9%[51.7-99.7]) and 9/10 (90%[55.5-99.7]), 7/7(100%[59.0-100]) and 8/8 (100%[63.1-100]); adjusted predictive values for Cp-susceptibility were 100%[66.4-100], 90.0%[55.5-99.7] and 100%[59.0-100], respectively.
Conclusions
In an MSM population, a novel, rapid integrated cartridge permitting 30-minute POC treatment with ciprofloxacin for Neisseria gonorrhoeae showed promising results on early diagnostic evaluation, particularly for genital and rectal infections. Further optimisation will improve clinical utility and enable directed antibiotic treatment in this population with significant prevalence of ciprofloxacin susceptibility.
Brief description of the abstract
We developed and evaluated a new point of care (POC) test for gonorrhoea and ciprofloxacin susceptibility on an existing commercial POC test platform. The results show real promise on genital and rectal samples from MSM. With imminent optimisation planned, the test will enable immediate ciprofloxacin treatment with confidence for a substantial proportion of patients with gonorrhoea while limiting use of “last available” antibiotics, such as ceftriaxone, currently used for empirical therapy.
Reference number
1145
Abstracts for this event were collected, handled and abstract book created by Conference Expert's Abstract Management System.