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Sexually transmitted infections (STIs) are a worldwide public health concern, with the ever-growing threat from antimicrobial resistance (AMR) impacting on treatment and disease management. The Applied Diagnostic Research and Evaluation Unit (ADREU) has been actively involved in the development, regulatory approval and implementation of rapid diagnostics for sexually transmitted infections and antibiotic resistance.

Preventing STIs and AMR would be helped by having affordable and accurate diagnostic platforms with the capacity to identify multiple pathogens as well as which antibiotics to treat them, all at the same time and rapidly.

Over the past few years ADREU, led by Professor Tariq Sadiq, has actively supported development, regulatory approval and implementation of rapid diagnostics for STIs. A major UKCRC Translational Infection Research Initiative grant awarded to St George’s (eSTI2) enabled ADREU to collaborate with industry partners Atlas Genetics Ltd and TwistDx®.

ADREU supported the calibration and evaluation of the 30-minute io® real-time rapid PCR detection diagnostic for Chlamydia trachomatis, resulting in CE marking in 2017. It also evaluated the 15 minute recombinase polymerase amplification test for detecting gonorrhoea and chlamydia. Further iterations of the io® platform, including a dual test for gonorrhoea and chlamydia and a four-pathogen test covering the major causes of STI-associated genital discharge syndromes, are also being supported.

By bringing its own IP to collaborations with industry, ADREU is now in the final stages of developing a rapid test for detecting both infection and antibiotic resistance in gonorrhoea which, once approved, may contribute significantly to addressing the serious threat of AMR in STIs. Ultimately the aim will be to enable vulnerable patients to be diagnosed rapidly and treated appropriately while reducing risks of the spread of AMR. 

Dr Sebastian Fuller, lead for the ADREU Social Science programme, is investigating facilitators and barriers to implementation of such diagnostics in sexual health clinics across the UK, enabling critical information for commissioners and health providers to support the NHS taking practical steps to implement these technologies.



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