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Four innovative tests for diagnosing UTIs to be considered for NHS use

By March 24, 2023No Comments

A NICE committee has seen promise in four tests which produce results in under an hour and can be carried out by a healthcare professional outside of a conventional laboratory in a primary or community care setting.

The technologies’ developers claim they can identify the presence of bacteria in a urine sample in less than 40 minutes. One can identify within minutes the strain of bacterial infection present. Another goes on to test which antibiotics are most appropriate to treat the infection.

Prescribing antibiotics to people without a bacterial infection adds to the risk of antibiotic resistance. Misdiagnosing a UTI or prescribing an ineffective antibiotic can also have a severe impact on a person’s physical and mental health and may result in a chronic UTI or in some cases, sepsis.

In draft guidance NICE is calling for further research to establish how accurately the tests detect and identify bacteria and test for which antibiotic is most effective, and how much the tests affect decisions about antibiotic prescribing.

If further research is done and suggests the tests could be beneficial if used in practice, they could help to improve antimicrobial prescribing, and be considered for conditional roll out for use in the NHS while further evidence on their clinical and cost-effectiveness is generated.

One fifth of antibiotics prescribed in 2019/20 in England were for lower urinary tract infections, 7m prescriptions out of a total of 31.4m, according to the NHS Business Services Authority’s RightCare UTI Focus Pack from 2021.

Mark Chapman, interim director of medical technology and digital evaluation, at NICE, said: “There is a need for new tests that can accurately identify whether an infection is present. Our Early Value Assessment project has identified that these four tests could help meet that need.”

Currently UTIs are diagnosed using a combination of clinical symptoms, dipstick tests and laboratory-based tests.

Dipstick tests are sometimes used as an initial test at the point of care, but they may not be accurate.

In draft guidance, the NICE committee has said that more data on the tests’ accuracy would allow better assessment of the potential risks and benefits of using them in the NHS. Ongoing studies may provide this for at least some groups (for example the TOUCAN study). Once further data is available, the committee will meet to decide if the recommendations can be reconsidered and if the technologies can be recommended for early access in the NHS.

A consultation on the recommendations has begun and feedback can be made via nice.org.uk until Tuesday 30 March 2023.

 

 

Natalie Creaney