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News | Press release | Partnerships | Scientific result | Health ＆ life sciences | Antibiotics | Diagnosis
The World Health Organization (WHO) has declared that antimicrobial resistance is one of the top global public health threats of the 21st century. It is possible that antimicrobial resistance will become the leading cause of death globally, ahead of cancer, accounting for 10 million deaths a year, 90% of which will be in Asia and Africa, due to the scarcity of resources. A more reasoned use of antibiotics is therefore crucial. To this end, a reliable test for bacterial susceptibility to antibiotics is needed. MSF has long been involved in efforts to tackle antimicrobial resistance, primarily in conflict-torn regions where MSF treats people with war wounds that become infected with multidrug-resistant bacteria.
In the industrialized world, identifying antimicrobial resistance is relatively simple thanks to automated electronic data systems developed to read and interpret antibiograms.
Microbiologists use Petri dishes containing an agar medium to culture bacteria samples taken from the patient being treated. Paper disks containing a given concentration of each antibiotic are placed in the dishes. The antibiotics diffuse into the agar, killing, or not killing, the bacteria present. If a bacterium is susceptible to the antibiotic, it disappears within a concentric zone around the disk: this is known as the inhibition zone. Antimicrobial resistance is categorized by measuring the diameter of these inhibition zones and comparing these measurements against reference charts, or breakpoint tables (see photograph on the right). Interpretation is based on precise rules specified by microbiologists.
We needed an app that
would cost nothing and be user-friendly, and we needed new algorithms to
efficiently process antibiogram images on a smartphone".
The application developed works offline, an essential feature for use in countries with limited resources. A photograph of the antibiogram is taken using the phone camera, and the app then guides the user through the analysis steps. The user can interact with the app interface at any point to check and, if necessary, adjust the automatic measurements.
To do this, it combines original algorithms, using machine learning and image processing. Last, an embedded expert system checks that the data is coherent and displays the interpreted results. The measurement procedure is fully automatic and achieves very high levels of reliability, with 98% agreement with the most reliable manual measurement methods currently in use.
The aim now is to adapt the mobile application for use in the low-resource settings in which MSF works. It should then be used to obtain high-quality antibiotic susceptibility tests for patients anywhere in the world, and could help further global surveillance of antimicrobial resistance.
In 2021, MSF is currently assessing the clinical effectiveness of the application in three different countries with a view to deploying its use at MSF laboratories by the end of the year. The app will then be made available to all test laboratories in countries with low resources by 2022.
With just a few months to go before completing these assessments and rolling out the app, MSF is calling on everyone involved in efforts to tackle antimicrobial resistance to come on board to make the app available to as many laboratories as possible in countries with limited resources.
AI-based mobile application to fight antibiotic resistance, Nature Communications
Marco Pascucci, Guilhem Royer, Jakub Adamek, Mai Al Asmar, David Aristizabal, Laetitia Blanche, Amine Bezzarga, Guillaume Boniface-Chang, Alex Brunner, Christian Curel, Gabriel Dulac-Arnold, Rasheed M. Fakhri, Nada Malou, Clara Nordon, Vincent Runge, Franck Samson, Ellen Sebastian, Dena Soukieh, Jean-Philippe Vert, Christophe Ambroise & Mohammed-Amin Madoui
CEA is a French government-funded technological research organisation in four main areas: low-carbon energies, defense and security, information technologies and health technologies. A prominent player in the European Research Area, it is involved in setting up collaborative projects with many partners around the world.