Antibiogo, an application to fight against antibiotic resistance

Antibiogo, a diagnostic tool allowing non-expert laboratory technicians to measure and interpret antibiograms.
As antimicrobial resistance (AMR) is a real public health threat, it was important to develop a tool that could be easily used in countries with limited resources, where antibiograms are often misinterpreted, for lack of means. Indeed, in 70 of the countries in which we work, we frequently observe patients arriving at hospitals with bacterial infections that do not respond to antibiotic treatment.

Antibiogo already routinely implemented in the DRC and Jordan, and soon in other MSF laboratories! Antibiotic resistance – Responding to the global health emergency. The MSF Foundation is taking action and offering a concrete response that can be used now in low- and middle-income countries.

  • 1.27 MILLION1: this is the number of deaths in 2019 worldwide, linked to antibiotic resistance;
  • 10 MILLION1: this is the number of deaths per year in the world from 2050, if nothing changes;
  • More than half of antibiotics are used inappropriately;
  • 400 YEARS: this is the number of years it would take in sub-Saharan Africa to reach the same ratio of pathologists including microbiologists / population as in the United States or the United Kingdom.

Antimicrobial resistance (AMR) is one of the most pressing public health threats of our time, according to the WHO. Health authorities estimate that more than half of antibiotics are used improperly and mostly in many low- and middle-income countries. In these countries, AMR cannot be measured due to a lack of technical and human resources to detect and monitor it. It therefore seems urgent to find rapidly deployable responses in order to respond to the health emergency and thus curb the spread of AMR.

The MSF Foundation (Médecins Sans Frontières) offers Antibiogo, the first CE marked in vitro medical device, designed, developed and tested for and with countries with limited resources. This tool, a reading application, makes it possible to interpret antibiograms and to give a practical and safe answer in order to secure the prescription of antibiotics. “Thanks to Antibiogo, any microbiology laboratory technician, anywhere in the world, will be able to read and interpret an antibiogram directly on a telephone and find out what the resistance profile of the bacteria responsible for infecting patients is. explains Doctor Nada Malou, Antibiogo project manager, MSF Foundation.

The fight against antibiotic resistance is based on a multidisciplinary response with the correct diagnosis as an essential pillar

Before initiating antibiotic treatment, it is necessary to identify with certainty the pathogenic bacterium, and to test its sensitivity to antibiotics. In this case, a bacteriological sample should be taken from the patient, and an antibiogram performed. In rich countries, the prescription of antibiotics is facilitated by the use of automatons for the reading and interpretation of antibiograms, and by the expertise of microbiologists. But in countries with limited resources, lacking this expensive equipment, clinical microbiologists, and training in test interpretation, the identification of antibiotic resistance is much more complicated or often absent. As a result, antibiograms are often misinterpreted and this observation has been very salient in the 70 countries in which MSF is present. Patients are frequently seen arriving at hospitals with bacterial infections that do not respond to antibiotic treatment.

To help doctors in low- and middle-income countries prescribe the most effective antibiotics to their patients, the MSF Foundation has created a tool capable of interpreting photos of antibiograms.

A safe and effective interpretation of antibiogram thanks to a revolutionary application: Antibiogo

Antibiogo is a diagnostic tool allowing non-expert laboratory technicians to measure and interpret antibiograms. It is based on image processing, artificial intelligence technology and an expert system that simulates the know-how of a specialist.
The application was developed by the teams of the MSF Foundation accompanied by a dozen developers from Google.org who supported them full-time and on a voluntary basis for 12 months and it benefited from a software exploitation license of one year. company expert in microbiology i2a. In practice, the application allows laboratory technicians to measure the diameters of inhibition found on antibiograms and then to interpret the results, without necessarily having expertise in microbiology. In situ, the results show a very high level of concordance, ranging from 90 to 98% depending on the bacteria, when compared with the interpretation made by qualified microbiologists.

Non-expert laboratory technicians working in low- and middle-income countries now have the ability to measure and interpret antibiograms to provide accurate results.

Antibiogo, a major hope for slowing down antibiotic resistance in countries with limited resources

Antibiogo is the first CE marked in vitro medical device, designed by the MSF Foundation. This tool, which is formalized in a free and downloadable application, provides a concrete response to slow down AMR in all countries by facilitating access to quality bacteriological diagnosis. Results can also be used for monitoring and updating empirical treatments based on actual etiology.

The Antibiogo application is already used in several MSF laboratories, particularly in Jordan and the DRC, and will be used by December in Mali, the Central African Republic and Yemen and is intended to be deployed more widely. Eventually, the application will become a tool for healthcare professionals in all countries with limited resources.

About the Antibiogo project

The MSF Foundation has set up a consortium with a French university hospital and several academic research centers in order to produce a proof of concept responding to the issue raised. They were supported in 2019/2020 by a dozen volunteer developers from Google.org and benefited from a software license from a company expert in microbiology i2a to help them move from concept to product. The MSF Foundation has been supported by legal, ethical, epidemiological and regulatory specialists in order to be able to make this in vitro diagnostic application available to as many people as possible free of charge.
For more information on Antibiogo:

About The MSF Foundation

Recognized as a public utility, the MSF Foundation supports projects that contribute to advances in humanitarian medicine and participates in the provision of tools for diagnosis, prevention and patient care aimed at improving the way MSF provides health care. Its mission: to deliver solutions to improve medical care in situations where MSF intervenes. The foundation’s teams are directly linked to the concrete problems observed on the ground. It is to respond to this that the foundation combines the resources and knowledge of MSF with the external skills of partners committed to complementary technologies and knowledge. Over the years and conducting R&D projects, the MSF Foundation has acquired expertise in the management of multi-partner projects with high uncertainty, as well as cross-functional skills in regulations, data protection, the implementation of an ethical framework and legal.

For more information on the MSF Foundation: https://fondation.msf.fr/frhttps://www.linkedin.com/company/la-fondation-msf/?originalSubdomain=en

Judicaël ZOHOUN

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Antibiogo, an application to fight against antibiotic resistance


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