The management of febrile patients is one of the most common and important problems facing healthcare providers. Distinction between bacterial infections and trivial viral infection on clinical grounds is unreliable, and as a result innumerable patients worldwide undergo hospitalization, invasive investigation and are treated with antibiotics for presumed bacterial infection when, in fact, they are suffering from self-resolving viral infection. We aim to improve diagnosis and management of febrile patients, by application of sophisticated phenotypic, transcriptomic (genomic, proteomic) and bioinformatic approaches to well characterised large-scale, multi-national patient cohorts already recruited with EU funding. We will identify, and validate promising new discriminators of bacterial and viral infection including transcriptomic and clinical phenotypic markers. The most accurate markers distinguishing bacterial and viral infection will be evaluated in prospective cohorts of patients reflecting the different health care settings across European countries. By linking sophisticated new genomic and proteomic approaches to careful clinical phenotyping, and building on pilot data from our previous studies we will develop a comprehensive management plan for febrile patients which can be rolled out in healthcare systems across Europe.

The aim of the PoC-ID project is to develop new micro- and nanoelectronic-based sensing and integration concepts for advanced miniaturised in vitro diagnostic devices. The project addresses the increasing demand for rapid and ultra-sensitive point-of-care diagnostics to reduce healthcare costs and increase the quality of life with a focus on infectious diseases, one of the world’s leading causes of morbidity and death. Interdisciplinary collaboration using the technology and expertise of the consortium members will be applied to develop and test a breakthrough PoC prototype for the diagnosis of respiratory syncytial virus infections and host responses in the paediatric context. PoC-ID will enable new types of point-of-care diagnostics for virtually any type of complex liquid sample. Applications are disease diagnosis, monitoring of therapeutic responses, clinical research of pathogen-host interaction and personalised medicine. The platform technology can easily be adapted to a variety of diagnostic or biosensing purposes, such as in health/environmental monitoring or food quality testing. PoC-ID will combine the detection of both pathogens and host responses leading to more accurate diagnosis as compared to the current standard which is focused on detection of pathogens only. This novel approach will support prevention and control of pathogen spread and enable faster and more personalised patient treatment. Improved performance in terms of robustness, sensitivity and selectivity will be reached by a combination of innovative nanomembrane technology, molecular engineered capture molecules and two novel sensing concepts. Further advances will be realised in terms of usability and speed of data-analysis arising from the integration of sensors, read-out electronics and microfluidics into one user friendly point-of-care (PoC) platform. Costs of the new disposable sensors will be ultra-low at high volumes, thanks to designing into microelectronics production flows.

Our proposal will address the challenge of bringing personalised medicine into routine use in EU healthcare systems for diagnosis and treatment of common infectious and inflammatory diseases, which account for a up to a third of all medical encounters in primary care and hospital. The diagnostic process in clinical medicine has been based on recognition of a constellation of symptoms and clinical signs, supported by laboratory tests. However, a definitive diagnosis is currently made in only a minority of patients presenting to healthcare with suspected infection or inflammation. We have previously shown that individual infectious and inflammatory diseases are characterised by unique patterns of host gene expression, and that diagnosis of individual diseases can be based on small numbers of uniquely expressed genes. We propose a new diagnostic classification of infectious and inflammatory diseases, based on the discriminatory ability of a minimal set of genes, which is able to distinguish all common conditions simultaneously, an approach we call Personalised Molecular Signature Diagnosis (PMSD). In partnership with 22 hospitals in 11 EU countries, and biotechnology groups in academia, SMEs and industry, we will develop a device to detect genes required for PMSD. We will then undertake a large-scale pilot demonstration in diverse healthcare settings in Europe, to establish the benefit to patients, reduction in healthcare resource use, cost effectiveness and acceptability to patients and carers, of PMSD.