Advancing Infection Prevention With Diagnostic Innovation: Insights From Alesia McKeown, PhD

Get Ready for Flu Day, September 17, 2024

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Infection prevention has never been more critical, especially in high-risk settings like hospitals and long-term care facilities. Diagnostic innovations are reshaping the landscape of infection control, providing faster, more accurate results that can dramatically reduce the spread of infectious diseases.

In an interview with Infection Control Today^® (ICT^®), Alesia McKeown, PhD, infectious disease scientific partner for Roche Diagnostics, highlights how advancements in molecular point-of-care (mPOC) diagnostics and flexible testing solutions are transforming health care practices. With rapid molecular tests bringing diagnostic capabilities closer to the patient, these tools enable faster diagnosis and intervention, often within the same patient visit. McKeown also discusses the growing demand for customizable testing options, the impact of rapid testing on respiratory illness management, and the integration of real-time data to enhance infection prevention protocols, ultimately improving patient outcomes across health care settings.

September 17, 2024, is also World Patient Safety Day!

ICT: How do you foresee integrating new diagnostic technologies in shaping the future of infection prevention protocols, particularly in high-risk settings like hospitals and long-term care facilities?

Alesia McKeown, PhD: Integrating new diagnostic technologies will significantly influence the future of infection prevention in high-risk settings like hospitals and long-term care facilities. One major development is increased access to molecular testing at the point of care. We have seen heightened interest in developing and implementing rapid, CLIA-waived molecular tests that bring testing closer to the patient. These easy-to-use systems enable faster diagnosis and intervention, ideally within the same patient visit, thereby reducing symptom onset and treatment time. This can be particularly critical in high-risk environments, where swift action is necessary to prevent the spread of infections.

Additionally, we are seeing an increase in the demand for more customizable and flexible testing options. These options will allow institutions to define their diagnostic multiplex panels, tailoring their infection prevention strategies to monitor local prevalence and respond uniquely to regional outbreaks.

As these technologies evolve, they will become essential tools in shaping infection prevention protocols, enabling faster, more targeted responses to outbreaks, and ultimately improving patient outcomes.

Alesia McKeown, PhD, is a scientific partner for infectious disease in medical and scientific affairs at Roche Diagnostics.

(Photo credit: Roche Diagnostics)

ICT: How do you think advancements in diagnostic technology can reduce the time between symptom onset and accurate diagnosis in respiratory illness cases?

AM: Advancements in diagnostic technology are significantly reducing the time between symptom onset and accurate diagnosis in respiratory illness cases. As previously discussed, one critical development is the rise of molecular point-of-care (mPOC) technologies, which allow for rapid, onsite testing. These technologies support a test-to-treat approach within a single patient visit, enabling health care providers to diagnose and begin treatment in one encounter. This improves patient outcomes and enhances antimicrobial stewardship by ensuring proper treatment starts as soon as possible. However, not all institutions can support mPOC testing. For those unable, flexible diagnostic solutions, such as placing rapid point-of-care (PCR) platforms in central laboratories for STAT testing, ensure that fast turnaround times are still achievable for critical cases.

Another crucial advancement is the focus on at-home sample collection, which allows patients to get tested without visiting a doctor’s office. This expedites diagnosis and helps control the spread of infection by keeping potentially infectious patients away from other vulnerable individuals. When combined with telehealth consultations, this approach enables a complete test-to-treat workflow from the comfort of home, providing both convenience for patients and an additional layer of infection control.

These innovations are shaping a more patient-centric health care model, where rapid and accurate diagnosis is accessible regardless of setting.

ICT: Can you explain how point-of-care (PCR) diagnostic tools or rapid testing technologies might streamline infection prevention processes within healthcare facilities?

AM: One of the critical infection prevention measures in healthcare settings is the swift identification and isolation of infectious patients. With POC molecular diagnostics, a patient presenting with respiratory symptoms, for example, can be tested on-site for common pathogens like influenza, respiratory syncytial virus (RSV), or SARS-CoV-2, and have results often within 20 minutes. If the test is positive, the patient can be immediately isolated, preventing them from spreading the infection to other patients, health care workers, or visitors. This reduces the risk of outbreaks within high-risk areas like emergency rooms, ICUs, and long-term care units.

Additionally, in health care settings where patient volumes are high, such as during the height of respiratory season or a viral outbreak, molecular POC diagnostics can help to identify clusters of patients with the same infection within an hour of intake. This allows for cohorting, ultimately reducing the spread of pathogens to uninfected patients and minimizing the need for cross-contamination prevention measures across the entire facility.

Another critical component of more sophisticated mPOC technologies is the ability to connect and interface with institutional health records and infection control dashboards. This capability allows health care facilities to track infection trends in real time, respond quickly to any increase in cases, and adjust their infection prevention protocols as needed.

ICT: How can the latest diagnostic technology help distinguish between respiratory illnesses with overlapping symptoms, such as influenza, COVID-19, and respiratory syncytial virus, to enable targeted treatment and prevention?

AM: Over the last decade, PCR has become the gold standard in pathogen detection for respiratory infections due to the technology’s high sensitivity and specificity for the unique genomic regions targeted in each pathogen. In response, targeted multiplex molecular assays have become the standard of care for most patients presenting with respiratory symptoms. These targeted multiplex assays are typically designed to detect two to five of the most common respiratory pathogens from a single patient sample. This capability is crucial because influenza, SARS-CoV-2, and RSV share many symptoms—such as cough, fever, and fatigue—that make empirical diagnosis by symptoms alone unreliable.

By identifying the specific pathogen causing the illness, these diagnostics enable health care providers to implement targeted treatments, such as prescribing antivirals for influenza or SARS-CoV-2. This precision also prevents the misuse of antibiotics for viral infections, improving antimicrobial stewardship and patient outcomes. Moreover, rapid and accurate identification allows for more effective infection prevention measures, such as isolating contagious patients, cohorting cases, and implementing targeted public health interventions.

These technologies also play a critical role in managing high-risk populations, such as older adults and immunocompromised, by enabling early and appropriate care. The ability to quickly and accurately differentiate between respiratory pathogens supports a more precise, effective, and timely response to respiratory illness outbreaks.

ICT: How important is having real-time, accurate diagnostic data in infection control decisions, and how do new technologies enhance your ability to act swiftly to prevent outbreaks?

AM: Real-time, accurate diagnostic data is critical for making informed infection control decisions and managing public health effectively. It enables rapid identification of pathogens, which leads to swift implementation of targeted treatment and containment measures. It also provides enhanced surveillance, leading to more efficient resource use and outbreak preparedness.

On a broader scale, real-time diagnostic data is vital for managing public health crises and outbreaks. Real-time data integration with electronic health records and infection surveillance systems enables continuous infection trends and patterns monitoring. This ongoing surveillance helps identify emerging threats, guide resource allocation more effectively, track the effectiveness of control measures, and adjust strategies as needed. This information can then inform local, regional, and national decision-making, guiding vaccination strategies, travel restrictions, and public advisories. The ability to track and respond to outbreaks in real time helps prevent widespread transmission and manage health care system demands effectively.