Overcoming the hurdles: A multidisciplinary approach

The use and application of syndromic testing are easily enhanced when utilised by a multidisciplinary team (with expertise in various areas) which can come together to make better-informed and appropriate decisions for the patient.

A physician is needed for their knowledge and interpretation of the current clinical picture of the patient, the relevance of indicative markers, a view of patient history, and for their knowledge and experience of difficult infectious cases.

Due to its increased sensitivity, a higher number of microorganisms may be identified compared to routine methods. Though a large quantity of data is good, the interpretation and understanding of this large amount of information is of the utmost importance.

These tests can pick up dead pathogens and genetic material not related to the infection and colonising bacteria — instead of the infectious microbe. These results, if not interpreted well, could lead to the incorrect and inappropriate use of antimicrobials. As well as physicians, expert microbiology laboratory staff are required to determine the results of the syndromic testing panel(s) to ensure the appropriate and most effective treatment is given.

The results from syndromic testing amount to merging three important components: the microorganism of the infection, potential drugs or treatment, and the host/patient. To correctly identify and treat the patient, information and knowledge from all three of these areas have to be combined. This includes knowing the identity of the microbe, and properties such as resistance genes and immune evasion capabilities.

Selecting potential drugs for treatment requires pharmacological knowledge of whether bactericidal or bacteriostatic properties are more appropriate. Additionally, such knowledge helps in assessing: whether the pharmacokinetics of chosen drugs are appropriate for the microbe and patient, the effect on the inflammatory response, and whether resistance towards the drug is developed.

The presence of an active antimicrobial stewardship program involving all active stakeholders is also vital within this process to ensure the relevant and necessary use of antimicrobials.

All this accumulated knowledge is used together to make an informed decision on the appropriate treatment regimen.

If you would like to explore this topic further, the accompanying PDF slides are available in the downloads section. Additionally, links to the references used can be found in the see also section below.