True blood

methicillin-resistant staphylococcus aureus mrsa bacteria
Methicillin-resistant Staphylococcus aureus (MRSA) bacteria

Kfir Oved took over his grandmother’s kitchen six years ago, and, using blood extracted voluntarily from friends and family, began work on a possible solution to the problem antibiotic resistant “superbugs.”

Oved, cofounder and chief technology officer of the Israeli company MeMed, and company cofounder and CEO Eran Eden, have developed a way to decode a person’s immune system to show in two hours whether that person’s infection is bacterial or viral, according to the results of a study of 1,000 people published last week in Plos One, a peer-reviewed medical online publication.

MeMed is working on bringing that time down to under 20 minutes. Currently, it takes two to three days for a blood test to come back from the lab, said Dr. Giorgio Kulp, medical director of Metropolitan Pediatrics in North Bethesda.

Kulp now makes an educated assumption as to whether the sick child in his office is suffering from a bacterial or viral infection. As a general rule, if the child has a fever greater than 104 degrees, Kulp considers the cause to be bacterial, and he prescribes an antibiotic.

“One of the things we struggle with in pediatrics, frankly, is how sick is the child,” Kulp said. “We have to be judicious” when prescribing an antibiotic.

If an infection is viral, antibiotics aren’t recommended. If it is bacterial, antibiotics are advantageous, but there is not one antibiotic that fits-all illnesses. Therefore, Kulp said, a quick diagnostic test would enable him to know if an antibiotic is needed.

“As a community, we lose [when antibiotics are overused] because the bugs in our midst become more resistant,” Kulp said. The more often a doctor prescribes antibiotics, the more likely it is that tougher, more resistant strains of the flu will rise up in the future.

The Centers for Disease Control and Prevention estimates that drug-resistant bacteria causes 23,000 deaths and two million illnesses in this country annually.

In an attempt to deal with this, the White House March 27 released a national five-year action plan to combat antibiotic-resistant bacteria and has allocated $1.2 billion in President Barack Obama’s 2016 fiscal year budget. That is nearly double the previous year.

“Antibiotics save millions of lives every year. Today, however, the emergence of drug resistance in bacteria is undermining the effectiveness of current antibiotics and our ability to treat and prevent disease,” according to a statement from the White House.

One part of the White House’s action plan calls for “advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria.” By 2020, the White House anticipates “significant outcomes,” including the widespread use of tests that can distinguish between bacterial and viral infections.

Officials at MeMed, an Israeli company created in 2009, believe the company’s scientifically-named ImmunoXpert in-vitro diagnostic blood test will do just that.

Currently, blood cultures taken from a patient are grown in a lab for a few days and then analyzed.

Under MeMed’s innovation, “we decided to try and cheat” and let a person’s own immune system do the detective work, Eden said. His company’s scientists worked out a way to decode the actions of the immune system as it detects and responds to the precise cause of an infection.

MeMed’s technology uses the fact that bacteria and viruses trigger different pathways in a person’s immune system. Researchers identified three soluble proteins that are uniquely activated by bacteria or viruses. MeMed developed algorithms that integrate these proteins and then identify the cause of the infection, Eden explained.

According to the study in Plos One, 1,002 patients in varying states of infections were tested using MeMed’s diagnostic blood test. The test “yielded highly accurate results, with sensitivity and specificity greater than 90 percent.”

Use of this blood test currently is available in two Israeli hospitals and also in a few European countries. The test is being reviewed by the United States’ regulatory process and may be in use here in two years, Eden said.

While determining the type of infection within two hours may be acceptable for a hospital that can hold off prescribing any medication for a short while, two hours is too long for a doctor’s office, where medication is prescribed during a brief visit to the doctor.

Therefore, MeMed is currently working to reduce that time to between 15 and 20 minutes. That is not as difficult as it sounds, Eden said. “All the hard core scientific work already has been done.”

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