More Related Content
Similar to Multi Specialty Presentation
Multi Specialty Presentation
- 1. Advanced Next Generation-DNASequencing of Bacteria, Fungal ,Viral
- 3. Pathogenius DNA MolecularDiagnostics. 13,000 DNA codes on file. Indifferent to time, media and transport issues.
- 5. Otitis Media Biofilm SinusCavity Biofilm
- 6.
- 7. Material from an infectedelbow prosthesis stained with the Molecular Probes • Seven Surgical Procedures • Over 5 years • Cultures consistently Neg • Case represented a landmark in the diagnosis of chronic bacterial infection in Orthopedic Surgery • PCR identified the infection
- 11. Dr. Caroline FifeDr. John Steinberg Dr. Chris Attinger Dr. James McGuire Dr. Berrylin Ferguson Dr. Donald Lanza
- 12. Planktonic Bacteria Single Cell BioFilm “Community of Bacteria” Cause of 80% of Infections Cause of ChronicWounds Will not grow in traditional culture Biofilm cells express a radically different phenotype than planktonic bacteria Only Diagnostic tool is Molecular Cause of Acute Infection Will grow in traditional Culture
- 14.
- 18. Diagnose –The physicianneeds to know what they are up against • The current diagnostic tool for identifying bacteria in the wound used by many physicians is traditional culture Culture – Means to Grow 1800Technology- Louis Pasteur based Microbiology 15 % Accuracy - Less than 5% of known bacteria will readily grow in the lab Culture Result – What they could grow , not what is in the wound biofilm
- 19. DNA Analysis vs.TraditionalCultures 51 Chronic wounds- Parallel Samples 16 S DNA Sequencing Traditional Culture • 46 /51 Staph Identified • 32 / 51 Pseud Identified • 28/51 Staph Identified • 8 / 51 Pseud Identified DNA Sequencing OutperformedTraditional Cultures DNA Sequencing identified 145 Genera – Cultures 14 !
- 21. “The impact ofproper specimen management on patient care is enormous” “Specimen selection and collection are the responsibility of the medical staff and not the laboratory”
- 22. American Society forMicrobiology Standard: Swab transport, RoomTemperature, 2 hours Current Lab: Swab transport, unknown temp, end of the day. High probability of error from the start.
- 23.
- 24.
- 26. Molecular Diagnostics ofNail Samples With Clinical Signs of Infection 59 % of Nail Samples had fungal Species Identified 41% of Nail samples had no fungal species but did have Bacteria species identified Nails with Fungal species identified also had Bacteria 3800 Nail Samples
- 29. Urine Data fromPathoGenius • Based on 1221 Urine samples • Escherichia coli 25% When seen – avg 73% of the sample • Proteus mirabilis 9% • Enterococcus faecalis 9% • Lactobacillus gasseri 8% • Lactobacillus crispatus 7% • Lactobacillus iners 5% We Identified a total of 507 species of Bacteria and Fungal in our urine samples
- 32. COST AND COVERAGEOF MOLECULAR DIAGNOSTICSTRADITIONAL CULTURE • MEDICARE PAYS $250 DNA SEQUENCING • MEDICARE PAYS $ 285
- 33. CUSTOMIZED FOR EACH PATEINTTOPICAL RX LIPOGEL BASED DOSED 3X WEEK CONTAINS ANTIBIOFLIM AGENTS ANTIBIOTICS ANTIFUNGALS
- 34. DNA Diagnostic “Mustbe expensive “ How much will it cost? Private Office If your patients are a Medicare patient, 100% of the cost of your testing will be paid by Medicare. Medicare reimburses $190 for our Level 1 and Level 2 If your patients have private insurance, 50% of Commercial Plans pay for the test. No sample will ever be denied by Patho Genius No Patient will ever go to collection
- 35. Benefits Pathogenius DNAMolecularTesting • Fast Identification of Biofilms and their composition in patients referred to you—Accuracy and Speed. • GOLD STANDARD of Microbial Diagnostics • Medicare Covers theTest and pay $190 • Less Expensive than a Culture
- 36. Stages of BiofilmDevelopment
- 37. Multiple Strategies arerequired to succeed against bio-films in chronic wounds Debridement –Is the “Corner Stone” Biocides Systemic Antibiotics Topical CustomizedAntibiotics
- 39. Diagnostic Services –What we deliver Two molecular microbial diagnostic tests are currently used at PathoGenius®. We take your patient's swab, washing, or tissue sample; extract the microbial DNA; and report the microbial analysis to you. Level 1: PCR 24-Hour Rapid Screening Screen 8 Common ENT Bacteria and 1 Fungal Provide Quantitative Bacterial Load Rapid turn around time of approximately 24 hours from the time of sample receipt. Pathogens Identified in Level 1 Staphylococcus (including MRSA) Streptococcus pyogenes (GAS) Haemophilus influenza Moraxella Catarrhalis Pseudomonas Streptococcus pneumonia Streptococcus agalactiae Candida albicans
- 40. Level 2: NextGeneration Sequencing Only lab in the country that can provide your patients access to DNA Pyro Sequencing Pyro sequencing matches the DNA from your sample to the entire universe of know bacteria and fungal pathogens Level 2 Report is fax/emailed to you in 5-7 days Level 2 Report includes a table of the pathogens identified and the antibiotics that will cover them. ( Antibiogram)
- 42.
- 43. The Neuropathic DiabeticFoot Ulcer Microbiome Is AssociatedWith Clinical Factors Sue E. Gardner,1 Stephen L. Hillis,2 Kris Heilmann,2 Julia A. Segre,3 and ElizabethA. Grice4 From the 1University of Iowa, College of Nursing, Iowa City, Iowa; the 2University of Iowa, Carver College of Medicine, Iowa City, Iowa; the 3National Institutes of Health, National Human Genome Research Institute Similar to other studies (7,12,36), we found that cultures do not fully represent bacterial diversity as compared with 16S rRNA gene sequencing. Microbial load is widely viewed as the reference standard for determining problematic bioburden in chronic wounds that may not express robust clinical signs (37).We demonstrated for the first time that cultures underrepresent the microbial load of the ulcer as compared with 16S rRNA gene approaches. These findings may have important clinical implications justifying the clinical use of molecular approaches rather than traditional cultures.
- 44.