Biotech firms take the battle to the superbug

Early-detection systems are being developed, writes Tim Webb, but they're meeting resistance in Britain
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The Independent Online

Methicillin Resistant Staphylococcus Aureus - the superbug to you and me - is crawling up the political and health agenda. Recently, it made it on to the front pages when Conservative leader Michael Howard revealed that his mother-in-law had died from MRSA, which she had contracted in hospital. The actress Leslie Ash also suffered an infection in hospital, although it was a less serious and she recovered.

Methicillin Resistant Staphylococcus Aureus - the superbug to you and me - is crawling up the political and health agenda. Recently, it made it on to the front pages when Conservative leader Michael Howard revealed that his mother-in-law had died from MRSA, which she had contracted in hospital. The actress Leslie Ash also suffered an infection in hospital, although it was a less serious and she recovered.

Not so the 5,000 patients who, the Department of Health (DoH) estimates, die from MRSA and other bugs caught in hospital each year in Britain. Around 9 per cent of patients in the UK pick up infections in hospital. Those who survive typically take a long time to recover. Treating infected patients costs the NHS an estimated £1bn every year.

So worried has the Government become that John Reid, the Secretary of State for Health, is launching a campaign this summer urging doctors and nurses to improve their hygiene and "wash their hands" to beat the bugs. The chief medical officer, Sir Liam Donaldson, also announced earlier this year that the drug regulatory process - which can delay a new launch for several years - will be fast-tracked for companies tackling MRSA. The DoH said this would help in its search for a "silver bullet" for the bug, and in identifying the most effective products from the mass offered by companies. These include bug-busting shower curtains, garlic extracts and a hydrogen peroxide aerosol spray.

Typically acquired in hospitals, MRSA is a common microbe that adapts to changes in the environment and develops resistance to normal medication. Patients whose immune systems are already compromised are particularly vulnerable.

Bill Mullen, the chief executive of Acolyte Biomedica, a diagnostic start-up, says: "Hospital-acquired infections [HAIs] have become a more serious problem over the last 10 years. Bacteria are varied, with each having its own particular characteristics, so they are difficult to measure accurately. A lot of the technology and knowledge used today dates back to methods from the last century."

But help is at hand, and more powerful than soap and water and special shower curtains. A host of small biotech and diagnostic companies are developing new ways of testing patients for MRSA, the most serious of HAIs. The earlier doctors can diagnose MRSA, the sooner they can begin treatment and improve the chances of survival. But the incubation period - the time between acquiring the infection and showing symptoms - is short, ranging from one to 10 days.

All patients are tested every week or fortnight for infections, including MRSA. In a typical UK hospital, 10,000 of these routine tests are carried out each year. At the moment, most hospitals rely on old-fashioned analysis in laboratories where scientists take swabs of blood or urine and watch the bacteria culture grow in petri dishes over a period of three of four days. Even then, it is not always easy to determine what kind of infection the patient has, so broad-spectrum antibiotics may have to be used which can help MRSA build up resistance, according to Graham Danks, the head biomedical scientist at New Cross Hospital in Wolverhampton.

One of the leading companies in the diagnostic market for MRSA is bioMerieux. Some 55 NHS hospitals (out of a total of around 350) use the French company's automated Vitek2 system, which analyses bacteria grown from a patient sample against a computerised profile of more than 2,000 drug-resistant bugs. The time between taking a sample and getting the results can be as little as 36 hours.

Mr Danks's hospital is among those embracing Vitek2. "At the moment, we use broad-spectrum antibiotics for longer than necessary," he says. "But using this technology we would be able to begin target treatment earlier. It saves a lot of time and resources and has been shown to cut down on HAIs."

But hospital managers in the UK are slower to adopt these new technologies than their counterparts on the Continent. Around 60 per cent of hospitals in France and Germany have installed Vitek2, against less than 15 per cent here. Stephen Jacques, bioMerieux's UK managing director, says: "British managers tend to be quite conservative."

Part of the reason for this is cost: systems such as Vitek2 are twice as expensive as traditional methods, which cost around £2 a test. But Mr Jacques argues that, in the long run, because of the earlier detection and treatment of patients with MRSA, Vitek2 will save the NHS money.

There are other alternatives. BD, a US diagnostics company, has developed a testing system called Phoenix which, as well as detecting MRSA, can pick up other infectious diseases such as E.coli. One Phoenix machine costs $95,000 (£52,000) and can carry out 100 tests at the same time, each costing $8.

John Meduri, the worldwide strategy director of BD, admits the cost puts many hospitals off, and has not yet begun promoting the system in the UK. "The market is small because of the use of manual systems," he says. "But we are working on a local and national level with the authorities to convince them of the merits of this kind of automatic testing."

Another firm that has yet to launch its MRSA diagnostic kit is Acolyte Biomedica. Using technology developed by the Ministry of Defence, it too claims to be more effective and efficient than existing products.

Analysts say the market in the UK is too small at the moment for the large pharmaceutical companies to get involved in making this kind of diagnostic equipment. A more attractive proposition for big pharma is helping to develop new drugs to treat MRSA and other drug-resistant bugs. GlaxoSmithKline has a joint venture with US company Biosynexus to do just this, though products won't be on the market for several years.

But, as the old saying goes, prevention is better than cure. And companies are hoping that the chief medical officer delivers on his promise to fast-track the fight against MRSA.

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