First published: 18/10/25 | Author: Carole Gough MSc FACSLM

I stood at a conference booth last week staring at a device that could prevent 10 million deaths a year by 2050.

It's already built. It's already proven. It won the £8 million Longitude Prize on Antimicrobial Resistance. And I'm willing to bet most healthcare decision-makers have never heard of it.

That's the problem we need to fix.

The Innovation: Sysmex PA-100 AST

The Sysmex PA-100 AST does something that sounds impossible: it identifies bacterial infection in 15 minutes and tells you which specific antibiotic will work in 45 minutes.

Compare that to current standard practice: lab cultures take 2-3 days to identify bacteria and determine antibiotic susceptibility. During those critical days, patients receive empiric antibiotic therapy - educated guessing based on likely pathogens and local resistance patterns.

Sometimes that guess is right. Sometimes it's not. And every incorrect guess contributes to the growing crisis of antimicrobial resistance.

Why This Matters: The AMR Crisis

Let me share some numbers that should make every healthcare decision-maker sit up and pay attention:

The Human Cost:

• Antimicrobial resistance (AMR) killed 1.3 million people globally in 2019

• Without intervention, that number becomes 10 million deaths annually by 2050

• That's more than cancer

The UTI Problem:

• Urinary tract infections affect 50% of women at least once in their lifetime

• UTIs account for 15% of all antibiotics prescribed in human medicine

• Current dipstick tests are inaccurate 40% of the time

• This inaccuracy leads to "just in case" prescribing that drives resistance

The Healthcare Impact:

• Patients wait days for the right antibiotic while infections worsen

• Hospital admissions that could be avoided

• Extended hospital stays when admission is necessary

• Increased healthcare costs across the system

• Continued development of antibiotic-resistant superbugs

The Science Behind the Breakthrough

What makes the PA-100 AST revolutionary isn't just speed - it's the elegant science that makes that speed possible.

The device uses nanofluidic chip technology with 11,000 nanochannels. Each channel is incredibly small - the entire chip fits in a smartphone-sized cartridge. These channels trap individual bacterial cells and expose them to microscopic quantities of different antibiotics.

Phase-contrast microscopy monitors bacterial growth in real-time. If bacteria grow despite antibiotic exposure, that antibiotic won't work. If growth stops, you've found your answer.

It's monitoring actual bacterial behavior, not relying on proxy markers or statistical probabilities. You're watching the bacteria tell you directly which antibiotic will work.

The result? Definitive antibiotic susceptibility results in 45 minutes instead of 2-3 days.

The Recognition: £8 Million Longitude Prize

The Longitude Prize on Antimicrobial Resistance challenged innovators worldwide to develop a rapid, affordable test that would help combat AMR. Over 250 teams competed.

The PA-100 AST won.

The prize recognized not just the scientific innovation, but the practical impact: a point-of-care test that could genuinely change prescribing behavior and slow the development of antibiotic resistance.

This isn't theoretical. It's proven, tested, and validated by independent assessment.

The Economics: More Than Just Clinical Benefits

Rapid antibiotic susceptibility testing delivers benefits that extend far beyond improved patient outcomes:

Direct Cost Savings:

• Reduced hospital admissions for infections that can be managed in community settings

• Shorter hospital stays when admission is necessary

• Fewer complications from delayed appropriate therapy

• Reduced need for broad-spectrum "big gun" antibiotics

Systemic Benefits:

• Genuine antibiotic stewardship, not just policy documents

• Slower development of resistance (protecting our antibiotic arsenal)

• Reduced burden on microbiology laboratories

• Better resource allocation across the healthcare system

Patient Benefits:

• Faster recovery with targeted therapy from day one

• Reduced anxiety during the diagnostic wait

• Fewer side effects from unnecessary antibiotics

• Better overall outcomes

The Irish Context: Right Place, Right Time

Here in Ireland, our community diagnostic initiatives champion "right place, right time" care. It's the right philosophy.

But innovations like the PA-100 AST show us what becomes possible when we extend that thinking to include cutting-edge diagnostics. When we recognize that 70% of clinical diagnoses depend on diagnostic testing, we start to see diagnostics not as a cost center but as a strategic investment in better care.

The technology exists. The evidence supports it. The business case is compelling.

The Real Barrier: Awareness and Priority

Here's what struck me most at the conference: this breakthrough innovation exists right now. It's not five years away. It's not waiting for regulatory approval. It's here.

So why isn't it everywhere?

The answer isn't technical or scientific. It's organizational and strategic.

Decision-makers don't know what they don't know. Budget holders see diagnostics as a line item to minimize, not a strategic investment to prioritize. Policy makers write strategies without point-of-care testing professionals in the room.

This is why my previous post about POCT teams fighting to be heard resonated with so many people. Because those of us working in this field know that solutions exist. We're just fighting to get decision-makers to pay attention.

What Needs to Change

We need point-of-care testing professionals at the table when:

• Healthcare strategies are being written

• Budgets are being allocated

• Service models are being redesigned

• Technology investments are being prioritized

Not after these decisions are made. Not as an afterthought to implement what's already been decided. At the table from the beginning.

Because we're the ones who know what's possible. We're the ones who understand both the science and the implementation challenges. We're the ones who can bridge the gap between innovation and impact.

The Opportunity

The PA-100 AST represents more than one impressive innovation. It represents what becomes possible when we:

• Prioritize diagnostic innovation

• Invest in point-of-care solutions

• Put POCT professionals in strategic conversations

• Make decisions based on evidence and outcomes

The innovations are here. The science works. The business case is proven.

The question is whether we'll use them.

About This Blog

I'm a medical scientist with extensive experience in biochemistry, POCT, and haematology. I've worked in diagnostic sales, training, and implementation with companies like Danaher and Abbott, and currently work as a change manager on national POCT implementations.

Through labwise.ie, I help medical scientists develop the practical skills beyond the bench that make POCT implementation actually work: stakeholder engagement, project management, change leadership, and strategic thinking.

Because the science is ready. Now we need to equip the people making it happen.

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References and sources available upon request. This article is based on publicly available information about the Longitude Prize on AMR and the PA-100 AST system.