A Maltese plastic surgeon has been awarded US and European patents for a pioneering blood test that could detect bacterial infections within 10 minutes at a cost of as little as €10.

The intellectual property rights relate to Ernest Azzopardi and his team’s test that involves comparing a blood sample from a suspect site to one taken elsewhere on the body.

Its aim is to improve patient care while helping to stem the rise of antibiotic-resistant bacteria.

“I hope in some small way to help alleviate patients’ suffering,” said Azzopardi.

“We are seeing more and more infections become resistant to antibiotics, with horrible consequences for any kind of surgery. Being able to correctly diagnose what needs treatment and what doesn’t is definitely a step in the right direction.”

The advancement is the result of around 15 years of research and has already attracted funding from the Royal College of Surgeons, UK research charities and the European Regional Development Fund, among others.

Azzopardi said the test for clinical use could take a minimum of around three years.

The University of Malta academic said the test takes less than 10 minutes and once scaled up, is expected to cost around €10, offering significant advantages over traditional tests.

“It is sometimes easy to be blindsighted by glitzy technology, and keeping the test affordable was quite the challenge,” he said.

“A crucial part of this research was making sure the way it is delivered is simple to read, affordable and available – rather than a high-tech, expensive kit that can only benefit a select few.”

Why is this needed?

According to Azzopardi, one of the main challenges posed in surgical environments is accurately determining the presence of invasive bacterial infections, with those affecting the skin and soft tissue – for example, muscles and blood vessels – a particular problem.

Describing such infections as having the potential to “lay to ruin” complex operations, Azzopardi explained that detecting them remained hit-and-miss.

I hope in some small way to help alleviate patients’ suffering

“Some bacteria routinely lie on the skin and cause no problems, but get treated anyway, while others really need quick treatment but may be missed,” he said, adding that conventional blood tests alone are not sufficiently fast or accurate, with further lab testing typically required.

How does the test work?

The test compares a blood sample from the infected site with one elsewhere in the body through, for example, a simple finger-prick test.

When a bacterium tries to infect the body, it causes blood vessels in that area to become ‘leaky’, causing swelling.

When this happens, large molecules can enter the bloodstream, something Azzopardi and his colleagues think they could be the key to quickly and cheaply detecting infections.

“We might have figured out how to harness that… by detecting one such molecule that just keeps seeping in and can’t get back out to the circulation,” he said, adding that initial clinical studies indicate an accuracy rate of around 90 per cent. 

“We went for a surprisingly unassuming molecule – probably the first enzyme to be first discovered – and one that can be simply and cheaply detected. It’s produced copiously by the body, has always been there, but nobody ever noticed it.”

The fight against antibiotic-resistant bacteria

Though further testing would be required to identify the strain of bacteria, detecting the presence of such an infection should allow doctors to immediately determine if antibiotics should be prescribed or not.

It is hoped this will prove an effective first-line defence against the over-prescription of such medicines which has been linked to the emergence of dangerous antibiotic-resistant bacteria such as MRSA.

“While nothing will supplant the expertise and experience of a well-trained health professional, this should help staff decide if antibiotics are needed or not,” he said.