We were part of a £1.6 million collaboration, which examined rapid testing to guide treatment for patients in intensive care.

Problem

Invasive candidiasis is the most common fungal infection affecting patients in hospital receiving intensive care. These patients also tend to stay over 5 days longer in intensive care compared to other patients. Furthermore the infection can be life-threatening in up to 60% cases. Some of these complications could be due to the ongoing challenges around diagnosing this infection. For example, currently, invasive candidiasis is mainly diagnosed using blood cultures which can take several days to produce a result. Moreover, each year, up to 11,000 of patients in intensive care receive unnecessary antifungal treatment. This costs the NHS around £12 million per year. Emerging technologies that test for the infection quickly and reliably could help to guide these treatment decisions. Consequently, this could reduce NHS costs and lead to better outcomes for patients.

Action

• We were part of the Antifungal Stewardship Opportunities (A-STOP) collaboration. This study received £1.6 million from the NIHR Health Technology Assessment Programme to identify better testing approaches for fungal infections.
• Led by The Queen’s University Belfast, the A-STOP collaboration examined the ability of three rapid tests to diagnose fungal infections. Overall the study recruited 1251 participants across 57 UK Intensive Care Units.
• We also interviewed 21 NHS staff and seven patients, or their legal representatives, to gather their views on the new testing strategy.

Outcome

• We found that rapid tests are effective at quickly “ruling out” Candida infection. Therefore they could be used in combination with standard testing to improve diagnosis and patient care.
• Interviewees agreed that the new testing strategy, if found to be accurate and affordable, could help guide decisions around antifungal treatment.
• Our interviews also highlighted the resources needed to implement this test across the NHS including staff considerations, lab facilities, training and established guidelines.

Impact

• Our insight panel and the NIHR Newcastle Clinical Research Facility (CRF) Public group helped to shape our research and patient recruitment strategy. This ensured that Patient and Public Involvement and Engagement was embedded throughout the project.
• Our engagement activities raised public awareness regarding antifungal resistance alongside the high cost and toxicity of antifungal drugs.
• We hope the study will lead to an update in clinical guidelines, leading to adoption of the testing strategy and improved patient care.

Find out more about our research

Find out more about the A-STOP study

[Photo by César Badilla Miranda on Unsplash]