Newcastle in international mission to develop rapid diagnosis for bacterial infections in children
Newcastle’s childhood experts are taking part in a £14m international EU funded mission to develop a rapid test to diagnose life-threatening bacterial infections in children.
Doctors and scientists, including leading authorities on infectious diseases & immunology at the Great North Children’s Hospital, have said that they are hopeful recent developments in research will lead to a simple, rapid two hour blood test which can determine whether a feverish child has a common virus or life-threatening bacterial infection such as meningitis, sepsis and pneumonia.
Dr Marieke Emonts – le Clercq, Consultant Paediatrician specialising in Infectious Diseases at the Great North Children’s Hospital and honorary Senior Clinical Lecturer at Newcastle University, is the clinical lead in Newcastle for patient recruitment and collecting information about how those patients at highest risk have reacted, both to their condition and the treatment given.
Dr Emonts explains: “Newcastle has an international reputation for its work into immunocompromised children with clinical care based on both the Bubble Unit and our oncology wards at the Great North Children’s Hospital.
“We have great experience in translational research and developing new and innovative treatments for young patients with serious, life-threatening conditions, with hugely successful results, so we are extremely well placed and very proud to help lead the way in this important field.”
The early symptom of most infections is a high temperature reaching to feverish levels. The difficulty is distinguishing between viruses and bacteria, yet this is vitally important.
Dr Emonts continues: “Fever is one of the most common reasons we see children brought into our hospital. In fact around 25% presenting to the RVI’s Children’s Emergency Department do so for fever.
“Thankfully the majority of children will simply have a viral infection which can be easily treated to bring the temperature down. However, we know from intelligence already gathered that 1 out of every 100 children we see will have a bacterial infection which if not treated immediately, can become fatal.”
Dr Emonts continues: “Through this major international collaboration we have already been able to identify two genes, one of which becomes activated by the child’s immune system when they have a bacterial infection, and the other when they have a viral infection. If we can test the condition of these genes rapidly through a blood test, we can be confident of getting the right treatment started immediately. Patient inclusion will start soon in our hospital so parents and their children attending A&E might be asked if they are willing to take part in this exciting research project.”
Dr Marieke Emonts
For the time being, when a child is admitted to hospital with a worrying fever, we have a scoring system in place to help staff identify children who may be at higher risk of a bacterial infection. Diagnosis can only be made by taking a sample of blood or spinal fluid and using this to see if bacteria grow. However, this can take over 48 hours. At the current time, there is no way of rapidly diagnosing whether it is due to a viral or bacterial infection.
Dr Emonts adds: “Because of the time taken for results to come back, we automatically start antibiotic treatment for any child we are particularly worried about. Thankfully, more often than not we will find they have a viral infection and they have had antibiotics unnecessarily which is not ideal.”
Overuse of antibiotics can lead to resistance to antibiotics. This is because the antibiotics kill off most of the bacteria, but there will always be a few that are resistant. They then multiply, propagate and pass on their resistance to other bacteria which pose a real threat for the future.
Dr Emonts continues: “We currently have a huge dilemma on our hands. We certainly don’t want to miss any bacterial infections, but conversely, we are doing all we can to reduce the unnecessary use of antibiotics. Additionally, we really don’t want to be carrying out lumbar punctures to take spinal fluids for testing unless absolutely necessary. So a rapid test based on the two genes we believe we have identified could literally transform clinical practice and stop meningitis and sepsis in its tracks.”
Professor Helen Foster, Professor of Paediatric Rheumatology at Newcastle University is the Children’s Clinical Research Speciality Lead at the Clinical Research Network North East and North Cumbria. She said: "It is really wonderful to have Dr Emonts and her colleagues lead this important area of research to improve the clinical care in children.
“Sepsis is a potentially fatal condition and the ability to identify those children who have life threatening sepsis from the myrriad of other causes of fever, will be a great advance in paediatrics. This is an excellent example of translational research – taking the clinical problem to help understand the basic science and then taking the basic science back to the clinical situation to improve patient care and potentially save lives. The Clinical Research Network North East and North Cumbria will do what we can to support the research team at GNCH to undertake this study"
This study is supported by the National Institute for Health Research (NIHR) and is part of the Newcastle Academic Health Partners, a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, and Northumberland, Tyne and Wear NHS Foundation. This partnership harnesses world-class expertise to ensure patients benefit sooner from new treatments, diagnostics and prevention strategies.
To assist in funding these important activities, we have just set up a new fund to support our Paediatric Infectious Diseases team at the Great North Children’s Hospital. If anyone has any great ideas for fundraising events or would like to make a donation to help support our work here, please contact our Charitable Funds Office on 0191 213 7235 or email Charity.Matters@nuth.nhs.uk and we can give you advice and support for your fundraising ideas. We also just set up a Just Giving address for anyone who would like to make a donation online at www.justgiving.com/GNCH-PIDFund and Text Code where you can make donations via your mobile phone by texting the message PIDF70 followed by the amount you wish to give (£3, £5 or £10) to 70070
For more information please contact Lynn Watson, Marketing & Communications Officer for the Newcastle upon Tyne Hospitals NHS Foundation Trust on 0191 223 1543.
Notes to Editors
PERFORM is an interdisciplinary project funded the European Union’s H2020 programme and involves 18 partner institutions in 10 countries aiming to link state-of the-art bio analyses and clinical markers to aid in early identification of the cause of the fever; viral, bacterial or inflammatory.
Professor Mike Levin at International Child Health, Imperial College London, is Chief Investigator for PERFORM. He said: “Rather than attempting to identify the bacteria, which has been the focus of most previous tests for bacterial infection, we believe bacterial infection can be recognised by the pattern of genes and proteins activated by the child’s immune system in response to the infection.”
In addition it will look at potential to implement new diagnostics in different European healthcare systems. In this way we hope to enable earlier targeted therapy.
Dr Marieke Emonts – le Clercq, Consultant Paediatrician specialising in Infectious Diseases and Immunology, and honorary Senior Clinical Lecturer at Newcastle University is the Principal Investigator for Newcastle. She will lead patient recruitment with an additional focus on the immunocompromised patients together with her team.
The PERFORM international team includes groups from Newcastle, Oxford, Liverpool, Spain, Austria, Germany, The Netherlands, Greece, Slovenia, Latvia, the Gambia and Switzerland, as well as the biotechnology companies Micropathology Ltd UK and bioMérieux, France.
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 668303.
Newcastle’s Great North Children’s Hospital and Newcastle University are proud to be involved in this international collaborative effort to better understand and diagnose childhood infections, aiming for early targeted therapy.
This study is part of the Newcastle Academic Health Partners, a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, and Northumberland, Tyne and Wear NHS Foundation. This partnership harnesses world-class expertise to ensure patients benefit sooner from new treatments, diagnostics and prevention strategies.