7th joint conference "Joint Microbiology & Infection Conference 2024" of the DGHM and VAAM

Abstract: Antimicrobial resistance is a major threat to human health globally and has changed the way medicine is practiced. Infections previously treated with oral antibiotics now require intravenous treatment, and, because whether an antimicrobial resistant bacterium may be causing infection is often unknown when therapy is initiated, unnecessarily broad-spectrum antibiotics are frequently prescribed, or alternatively, the prescribed regimen may not even treat the infection because of unrecognized underlying resistance. In addition, antibiotics are given to those who do not need them because they do not have a bacterial infection. Antibacterial resistance involves hundreds of microbial species, dozens of antibiotics, and many clinical syndromes. While development of new therapeutics and antimicrobial stewardship are needed, better diagnostics and appropriate use thereof need to be better incorporated.  
The classic three-step diagnostic paradigm used in medicine, taught to students, and applied by medical professionals, involves asking whether a clinical presentation could be due to infection (step 1 – based on history, physical examination, initial tests), what the causative microorganism(s) might be (step 2 – based on culture, serologic testing, molecular testing for microorganisms), and finally, which treatment should be administered (step 3 – based on culture-based antimicrobial susceptibility testing). This approach, although intellectually interesting, is at once contributing to the antimicrobial resistance crisis and failing because of it. Creative use of technology can help; fortunately, we are in a technology revolution in terms of microbial diagnostics. There have been major advances in the application of proteomics, nucleic acid amplification tests and sequencing-based diagnostics, microbial imaging, microbial metabolomics, and advanced host response assessment for infectious diseases in recent years, and point-of-care diagnostics are transforming where testing can be done. Modern diagnostic tests can curb emergence of antimicrobial resistance by informing improved antibiotic use (a patient and societal benefit), leading to avoidance of unneeded testing and treatment (a patient benefit), decreasing transmission of infectious diseases (a societal benefit) and informing new discoveries and better delivery of healthcare (which will have future benefits).  
This presentation will overview how, with improved diagnostic testing, medicine can undo the classic and slow diagnostic paradigm, using diagnostics that detect microorganisms and directly call out ideal therapy in a single step, so-called, microbial “theranostics”. 

Microbial Theranostics – A Resistance Combatting Strategy

Barbarossa Saal

Robin Patel

Plenary Speaker