Defining System Requirements for Simplified Blood Culture to Enable Widespread Use in Resource-Limited Settings
Foundation for Innovative New Diagnostics (FIND), Malaria and Fever Program, Chemine des Mines 9, Geneva 1202, Switzerland
Division of Infectious Disease & Vaccinology, School of Public Health, University of California, Berkeley 94720, CA, USA
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, UK
Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
Department of Pathology, Stanford University, Palo Alto 94304, CA, USA
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Pole of Clinical Research, French Institute of Health and Medical Research, Paris 75013, France
Department of Epidemiology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg 20359, Germany
Kinshasa Mahidol Oxford Research Unit, University of Oxford and Kinshasa School of Public Health, Kinshasa, The Democratic Republic of Congo
Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
National Health Laboratory, Gaborone, Botswana
Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Diagnostics 2019, 9(1), 10; https://doi.org/10.3390/diagnostics9010010
Received: 15 October 2018 / Revised: 20 December 2018 / Accepted: 26 December 2018 / Published: 11 January 2019
(This article belongs to the Special Issue Diagnosis of Bacterial Pathogens)
Bacterial blood stream infections (BSI) are a common cause of mortality and morbidity globally. As the causative agents and the resulting treatment decisions vary, near-patient testing and surveillance tools are necessary to monitor bacterial causes and resistance to antimicrobial agents. The gold standard to identify BSIs is blood culture (BC), a methodology not widely available in resource-limited settings. The aim of the study was to map out a target product profile of a simplified BC system (SBCS) to inform product development efforts. To identify the desired characteristics of a SBCS, we enlisted a small group of specialists working in Africa and Asia. Questions were used to understand challenges and how these constraints inform system requirements. The specialists were infectious disease physicians, public health/clinical microbiologists, clinical researchers, and technology experts with different geographical backgrounds. All suggested that BC should ideally be available at the district hospital level. Many of the same operational challenges, such as limited availability of culture bottles, electricity and internet connectivity, profuse dust, the lack of ambient temperature control, and human capacity constraints were identified across the different regions. BCs, although the accepted gold standard for diagnosis of BSIs, are not widely available outside of reference/research centers in Africa and Asia. To extend the reach of this important tool, it is crucial to engage product developers and academic research partners to develop accessible alternatives.