Company insight
Catching Covid – and other bugs
Today, more than ever, output of clinical laboratories is key for adequate and timely treatment of infected patients. Bruker endeavours to contribute to human healthcare by offering innovative solutions for microbiology and diagnostics.
round 18 months since the WHO’s official announcement of the novel coronavirus outbreak as a pandemic in March 2020, scientists continue their hunt for information on how to tackle Covid-19. It is well known that individuals with comorbidities such as respiratory tract conditions, diabetes and obesity are at greater risk of becoming hospitalised with Covid-19, but comparatively little is known about what happens to the body when patients are co-infected with other pathogens. Diagnosing and treating Covid- 19 co-infections is not straightforward; a secondary infection could go undiagnosed in the face of SARS-CoV-2 primary infection, especially if symptoms overlap. Diligent testing of Covid-19 patients for other infectious diseases is vital. Patients with severe Covid-19 disease in intensive care units are at increased risk of hospital- acquired infection and need to be carefully monitored to allow rapid treatment decisions.
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the under-representation of clinical mycology in infectious disease medicine and the relatively fewer healthcare professionals with specific expertise and awareness, is likely to contribute to the underdiagnosis of fungal co-infections.
Covid-19-associated pulmonary aspergillosis (CAPA) caused by Aspergillus spp is the predominant fungal disease reported among Covid-19 patients with acute respiratory distress syndrome (ARDS), with mortality rates ranging from 44–67%. Researchers have highlighted the importance of fast fungal identification to aid early treatment. Rapid and reliable molecular testing such as polymerase chain reaction (PCR), alongside other biomarkers and culture methods, can reduce the time to diagnosis and support physicians in optimising patient management. Bruker’s Fungiplex Aspergillus IVD Real-Time PCR Kit detects the primary species associated with invasive aspergillosis, providing results
“Diagnosing and treating Covid-19 co-infections is not straightforward; a secondary infection could go undiagnosed in the face of SARS-CoV-2 primary infection, especially if symptoms overlap.”
Improving clinical awareness Although the reported incidence of bacterial, fungal, and viral co-infections in hospitalised Covid-19 patients is relatively low, when present they may cause severe diseases with poorer outcomes. Some studies have reported a higher incidence of secondary infections in patients admitted to ICU, and those diagnosed with secondary infections had lower discharge rates and higher mortality rates than those without. Symptoms of some fungal diseases can be similar to Covid-19, including fever, cough, and shortness of breath. This, together with
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in less than two hours, and can be easily implemented alongside Covid-19 workflows. Tuberculosis (TB) also shares clinical features with Covid-19, such as a cough and fever, which could impact diagnosis time. We need to improve our understanding of how Mycobacterium tuberculosis and SARS- CoV-2 interact in co-infection cases, to aid the development of therapeutic strategies. Rapid TB screening and susceptibility testing are vital in light of recent reports of multi- drug resistant (MDR) TB in Covid patients. Molecular genetic assays, such as Bruker’s GenoType MTBDRplus and
GenoType MTBDRsl assays, allow the simultaneous detection of M. tuberculosis complex and its resistance against first and second-line antimicrobials. The FluoroType MTB and FluoroType MTBDR assays, based on Bruker’s LiquidArray technology, enable the detection of M. tuberculosis complex and identification of mutations within the rpoB, inhA and katG genes directly from specimens in less than three hours, respectively.
A complicated clinical picture Most Covid-19 patients admitted to ICU show a dysregulated host response characterised by hyperinflammation, alterations in coagulation and dysregulation in the immune response that contributes to multiple organ failure – common clinical features to sepsis. There is a need to better understand the relationship of molecular mechanisms dysregulated by SARS-CoV-2 that can lead to sepsis, the risk factors for co-infection in Covid-19 patients, and how Covid-related sepsis impacts morbidity and mortality.
As a fast and cost-effective tool for unbiased identification of microorganisms, Bruker’s IVD MALDI Biotyper (MBT) can be integrated into almost any clinical laboratory environment, allowing microbiologists to obtain an identification from culture in minutes, based on proteomic fingerprinting. The MBT Sepsityper IVD Kit, used in conjunction with the IVD-CE MALDI Biotyper, can identify pathogens from positive blood cultures within 15–20 minutes in an efficient workflow that allows timely clinical decision-making in sepsis cases.
For more information about Covid-19 co-infections, download Bruker’s white paper on the company’s website. ●
www.bruker.com/microbiology Practical Patient Care /
www.practical-patient-care.com
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