Road map to saving a million lives

Road Map to Saving a Million Lives

By Tierney Muir

Want to save a million lives? More efficient diagnostics could do it.

When you go to the hospital, you go with the expectation that you’re going to get better. You’re not thinking that you might get an infection and end up worse off than before.

The likelihood of getting an infection while in hospital is one in 20 and, in Canada alone, hospital visits result in 200,000 infections and 8,000 deaths per year.

But the scary part isn’t the stats, it’s that much of the death and illness is aggravated by slow diagnostic testing — an area of our health-care system and health research that is often overlooked, but has compounding, life-threatening implications.

Lucky for us, UCalgary researcher Dr. Ian Lewis, PhD, didn’t overlook the opportunity and hopes to change the stats through his rapid diagnostic research and partnership with Calgary Lab Services. The team, based out of Calgary Centre for Rapid Diagnostics, are developing faster, better, more precise testing. The end goal? Save a million lives.   

So why do people die from infections and what can be done?

We spend billions of dollars on problems that are really hard to fix. Terrible things like heart disease, diabetes and cancer are nearly insolvable problems. However, “people also die from really stupid things — things that are solvable,” says Lewis. “It just requires applications of effort and recognizing that there is a problem.”

People also die from really stupid things — things that are solvable. It just requires applications of effort and recognizing that there is a problem.

Dr. Ian Lewis, PhD

Super bugs: you should be worried

You’ve probably heard of drug-resistant infections or “super bugs.” These bugs are becoming more and more resistant and we should be worried. In the foreseeable future, North American life expectancy is thought to decrease by 20 years as a result of our inability to control common infections, Lewis told alumni at Idea Exchange San Francisco. Modern medicine requires antibiotics. Everything from joint replacements to chemo treatment and organ transplants are not possible in a world where antibiotics are unreliable. There will come a time when clinicians will have to weigh the risk of you getting an infection with the benefits of undergoing surgery.

Current technology is what could stand between you and dying in a hospital bed

Lewis indicates that current lab testing technology contributes to antibiotic resistance because it takes so much time to test and identify the proper treatment. In the meantime, in an effort to help the patient, the doctor takes a guess and may end up prescribing a less-effective or ineffective antibiotic, resulting in overuse and misuse of the drugs.

Here’s a step by step on the current lab testing process:

You’re at the hospital or you’re not feeling well, so you go to the doctor.

Step 1

Your doctor evaluates your ailment and determines you may have an infection, writes up a lab requisition and may prescribe you an antibiotic based on what they think the infection is.

Step 2

After you have seen your doctor, you go to the lab and a tech draws your blood to capture a sample for testing.

Step 3

Your vial of blood goes to the lab incubator where the bacteria grow and, in one to two days, the lab can determine which bugs are present in the sample.

Step 4

From there, the lab needs to determine which antibiotic will kill the bacteria. This takes another two to four days.

Finally, the results are sent to your doctor two to five days later.

Doesn’t seem too bad, right? But the thing is that, meanwhile, the patient is waiting and getting sicker. Your probability of dying is based on how fast the bacteria makes babies. So every hour that elapses between the onset of symptoms to you getting the right drug effects your chances of survival.

Turning garbage into gold

It turns out that the biomarker for savings lives is currently quite literally garbage. Using blood samples in old vials obtained from Calgary Lab Services that ordinarily would just be thrown away as medical waste, Lewis’s team tested different antibiotics on various infections and discovered that, if you give a microbe a dose of the right antibiotic, it stops metabolizing. This happens very quickly. This means that, instead of waiting for two to five days for the proper diagnosis and precise treatment, it’s possible to determine which bug needs what drug in four hours or less.

The head-to-head UTI race

Lewis’s team decided to test the new technology on a common type of infection — urinary tract infections (UTI). Most UTIs are not serious, but patients who are given the wrong antibiotic are at a significantly higher risk for developing urosepsis, a life-threatening condition. Using this new metabolite-based approach, Lewis’s team raced Calgary Lab Services — the most streamlined and largest clinical testing lab in North America — to see who could detect and determine the appropriate treatment of a UTI first. Lewis’s team beat CLS by 30 hours.

How will we save a million lives?

People die from infections that could be cured with the right antibiotic. We simply lack the tools necessary to match patients with the right antibiotics fast enough in a real-life clinical setting, says Lewis. The next step is to get this new technology into the health-care system, but that takes time. 

The creation of the Canada Centre for Rapid Diagnostics will ideally speed up the process and get this and other new diagnostic testing technology to market faster by having lab techs, doctors, researchers and commercialization experts all working together.

Dr. Ian Lewis, PhD

UCalgary researcher Dr. Ian Lewis, PhD, talks to audiences at Idea Exchange San Francisco, on Oct. 29.

Idea Exchange and the Energize Campaign

UCalgary’s $1.3 billion Energize campaign fuels innovations that advance health and wellness. Together, we will inspire discovery, creativity and innovation to advance health and wellness, and strengthen vital community connections.

Our goal is for UCalgary to be recognized as one of Canada's top 5 research universities.

This content was developed from the Idea Exchange in San Francisco event that took place on Oct. 29, 2018. Learn more about exploring big ideas at Idea Exchange.

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