Breakthrough DNA test to identify all drug resistance mutations in Tuberculosis
MedGenome Labs forays into Infectious Disease Testing with a unique offering of genetic tests across Tuberculosis, CNS, Systemic and Eye infections
MedGenome Labs- leader in clinical data driven genetic diagnostics and drug discovery research in India, has de veloped ‘SPIT SEQ’, the first Whole Genome Sequencing based test that can provide a detailed analysis of every single mutation present in any tuberculosis bacteria causing drug resistance-directly from the sputum. This bre ak-through will enable a doctor to quickly and accurately prescribe the most effective drug to a tuberculosis pa tient without a trial and error process, followed currently that takes a month.
India has the largest number of multi drug resistant (MDR-TB) TB cases. SPIT SEQ can be a boon for TB patients, clinicians and healthcare agencies to achieve India’s Sustainable Development Goal (SDG) of elimination TB by 2025. The test is based on whole genome sequencing of mycobacterium tuberculosis (MTB), the TB causing bac teria, to assess the mutations in bacteria’s genome and allows a clinician to determine which drugs will work for a patient.
This test has been validated with over 100 samples where it recorded with 100% sensitivity and 98.04 % specifi city when compared with Line Probe Assay (LPA). 50 out of those samples were in association with P.D. Hinduja Hospital and Medical Research Centre, Mumbai. A manuscript is under review for publication. Typically, the pr ocess of analyzing the drug resistance is very long which delays treatment for MDR-TB patient. Here as well, the current expertise allows testing resistance only on 4 drugs hence the patient had to wait until testing on all possi ble drug concluded. In such a situation, where long turn-around diagnosis time, repeated testing led to multiple changes in the course of treatment along the way.
“Direct Whole Genome Sequencing reveals information on drug resistance mutations for all anti TB drugs in a matter of 10 days. Soon, this technology will help in optimizing the precise management of an MDR-TB patient”, says Dr Camilla Rodrigues, P D Hinduja Hospital and Medical Research Centre, Mumbai.
According to WHO report, there were 2.7 million TB cases (incidence + relapse) in 2017 and India accounted for 27% of global TB deaths. Second most appalling insight is that globally, 3.5% of the new TB cases and 18% of pre viously treated patients suffered from relapse due to the immunity developed by tuberculosis bacteria. The conv entional tests available in the country equip us to identify resistance in a limited fashion. Mtb (Mycobacterium t uberculosis) is slow-growing, taking 6-8 weeks for culture growth, thereby delaying not only TB diagnosis but als o the drug resistance testing. SPIT SEQ is a culture-free WGS (whole genome sequencing) method for identificati on of Mtb and prediction of drug resistance with a turnaround time of 10 working days. Another strength of WG S over rapid molecular tests (LPA) is in the resolution of non-interpretable (NI) results that occur when a locus of interest has neither the wild type nor the specific mutation of interest present. A total of 12 such mutations wer e detected by our SPIT SEQ WGS test which was missed by LPA.
“SPIT SEQ is a massive breakthrough that can help millions. This particular test not only brings accurate results but also saves a lot of time where TB treatment is concerned. In lines with India’s obje ctive to counter TB effecti vely and quickly, we aim to benefit the last person living with TB today”, said Dr VL Ramprasad, COO, Med Genome Labs.
With the flagship test for tuberculosis ‘SPIT SEQ’, MedGenome L abs is entering into infectious disease genetics and collaborating with XCyton Diagnostics, Bangalore. This collaboration will boost integration of various gene tic tests under infectious diseases available with XCyton through the network established by MedGenome Labs. These tests include eye infections, brain and blood infections. MedGenome will be the exclusive sales partner for all XCyton tests in India. “Infectious diseases remain a major challenge, leading to significant healthcare expend iture, for India. This partnership can act as a synergy in India’s quest against infectious diseases. MedGenome’s reach across India’s geography will prove to be pivotal in the success of integrating genetic testing in healthcare service segment while we at XCyton continue to be focused on research and development of current as well as new tests.” said Dr B V Ravikumar, Founder and Managing Director, XCyton Diagnostics Ltd.
“Our ultimate objective is to bring down the burden of healthcare we have currently. It is possible if we are able to harness the power of genomics completely and mainstream that into our healthcare ecosystem. Globally, Ge nomics is a well-recognized field that fuels innovation not just in diagnosis but also in drug discovery. While India is steadily moving in that direction, collectively we need to acknowledge its potential and leverage upon the sa me”, adds Ramprasad.
Present at the event were Dr Sachin Suresh Jadhav, MD DM, (Clini cal Hematology), Group Head, Haematology and BMT, HCG Group of Hospitals and Dr V Ravi, Senior Professor and Head, Dept. of Neurovirology, NIMHANS who explained how highlighted the vul nerabilities to infections and stressed upon the integration of gene tictes ts in everyday practice to counter that effectively. “Resist an ce to antibiotics is not uncommon and is now recog nised as an em erging public health concern demanding attention. There are multiple recorded examples of mult i-drug resista nt fungal infections responsible for mortality as high as 40 percent in organ transplantation. While there are tes ts existing to examine the state of a patient, ignorance and delays in initiating effective therapy has led to loss of life. Early diagnosis and prompt microbiological tests and crucial to save lives”, said Dr Jadhav. Amo ngst all infec tions of human beings Blood stream infections (Sepsis) and infections of the brain (Meningitis and encephalitis) pose the greatest challenge to physicians. Firstly, they are serious, life threatening infections with high morb idi ty and mortality, secondly, they provide a very small window (72 hours) for diagnosis and appropriat e ther apeu tic intervention and lastly a large number of micro-organisms are known to cause these infections. It is in this context, that experts came together for the development of the Syndrome Evaluation System (SES) for both thes e life-threatening infections to develop a diagnostic assay that can simultaneously detect a number of micro-organisms that are known to cause these infections within a few hours and wherever possible provide the antibiotic susceptibility of the organisms especially in blood stream infectio ns.
It has been extensively validated at several reputed institutions in the country such as NIMHANS, St Johns Med ical College Hospital etc before it was put to use in the clinical arena. There are several publications in reputed jo urnals that have evaluated the highlighted utility of this technology. Although SES was initially intended to me et the diagnostic needs of clinicians, it became apparent after introduction into clinical practice that it is a pow erf ul management tool that can save lives, reduce morbidity and hospitalization costs”, said Dr V Ravi
MedGenome is the current market leader in this industry to have studied genetic disposition in multiple therapy areas like Cancer, Reproductive Health, Rare Diseases amongst others in the country.
About MedGenome Labs:
MedGenome is a genomics and clinical data driven diagnostics and drug discovery research company founded in 2013. With the state-of-the-art Next Generation Sequencing (NGS) facility, MedGenome is one of the highest th roughput NGS sequencing & CAP accredited lab in South Asia. MedGenome offers comprehensive diagnostic sol utions to researchers, doctors and hospitals and its belief in continuous innovation has led to the development o f many new genetic tests. MedGenome’s clinical, phenotypic and genomics data, provide insights into complex di seases and aid in drug discovery. MedGenome, a founding member of GenomeAsia 100K, initiated to sequence 100,000 Genomes in the Asian Population to create gene-pool data for higher research purposes. For further in formation please visit https://diagnostics.medgenome.com/