Battered brains, germs and genes: Tomorrow's POCT empowering enhanced healthcare

9.30am – 11am BST, 11 June 2025 ‐ 1 hour 30 mins

Parallel session

In this session, we’ll explore how point of care testing continues to revolutionise clinical decision-making, particularly in critical and high-acuity settings. We’ll cover a range of topics, branching out from traditional POCT disciplines, including MT-RNR1 gene testing in neonates with sepsis to detect susceptibility to aminoglycoside-induced ototoxicity, a crucial step in preventing hearing loss and later need for cochlear implants. We’ll also discuss how POCT can be used in the management of traumatic brain injury to reduce unnecessary CT scans, improving patient care, minimizing radiation exposure and reducing the burden on radiology departments. Additionally, we’ll look at the role of POC testing in urinary tract infections, and its vital contribution to antimicrobial stewardship, helping to optimize treatment at the first encounter and prevent overprescription. These advancements are setting new standards in healthcare, improving patient outcomes, and enhancing resource efficiency. We’re excited to share insights into these cutting-edge developments and their impact on clinical practice.

Chair:  Fiona Riddoch

9.30  Genetic POCT – Greater Manchester POCT network experience - Sharman Harris
​​​​​​​The development of innovative Genetic POCT testing enables rapid personal prescribing decisions at the point of need, avoidance of adverse patient outcomes and reduction in associated healthcare costs, however it also presents new challenges for the POCT community and Clinical teams.  The Greater Manchester (GM) POCT network collaborated with Health Innovation Manchester, Manchester University and Industry in evaluating a genetic POCT to guide antibiotic prescribing in neonates (Genedrive –MT-RNR1) which can reduce aminoglycoside antibiotic induced hearing loss.  This genetic POCT was implemented across Trusts in Greater Manchester within National POCT standards. This talk will cover the various challenges encountered, developing solutions and the need for future commissioning of genetic POCT.

Gentamicin is an aminoglycoside antibiotic and a first line treatment for sepsis in neonates. Guidelines recommend treatment within 1 hr, however one in 500 individuals carry a mitochondrial gene variant m.1555 A>G that causes severe irreversible hearing loss if treated with Gentamicin. Current testing in the laboratory takes a minimum of 3 days. The Genedrive –MT-RNR1 can detect m.1555 A>G in under 30 minutes from a cheek swab and avoid lifelong hearing loss in affected individuals. In 2023 NICE (MedTech Innovation Briefing) recommended the use of Genedrive MT-RNR1, while further evidence is generated.

The GM POCT network collaborated from early days of development at a specialised Neonatal unit to developing a GM wide POCT verification plan with POCT support costs  provided (based on the GM POCT verification guide and GM POCT finance guide) for implementation at all Trusts including smaller Neonatal units at District general hospitals with varied antibiotic protocols. Supporting the transition from innovation to a routine POCT service was challenging, however the importance of POCT team management was demonstrated.  Including clinical consultancy and support for verification, operator training, competency, reducing failure rates, IQC monitoring, EQA development, connectivity, troubleshooting and SOPs/documentation.

The PALOH study (Pharmacogenetics to avoid loss of hearing-UK) is currently ongoing to address the evidence gaps outlined by NICE-EVA (early value assessment) and GM POCT network are providing ongoing support to demonstrate whether Genedrive MT-RNR1 POCT can be integrated into routine neonatal care pathways with POCT management to guide antibiotic therapy during this study.

Genetic POCT commissioning remains to be addressed at a local and national level.

10.00  AMS for urinary tract infections in the community; a role for point-of-care testing? Philip Turner
Acute uncomplicated urinary tract infections (UTI) are one of the commonest presentations in primary care settings. Around half of all women experience one or more episodes in their lifetimes and a quarter of all culture-positive infections are associated with resistant uropathogens. European estimates have shown that although approximately 30% of symptomatic primary care patients have a culturable infection, the majority receive antibiotics. Safe optimisation of antibiotic prescribing is a key element of AMS, however existing diagnostics for UTI accessible to acute care settings are insufficient to influence immediate decision making, being either too slow or adding minimal diagnostic value.

Recent years have witnessed the emergence of multiple novel point-of-care diagnostics for UTI, with assays of sufficient interest to motivate the publication of NICE Early Value Assessment HTE7 on this subject and with one candidate awarded the prestigious Longitude Prize on AMR. During this talk we will explore the role point-of-care tests for UTI might play in antimicrobial stewardship in community healthcare settings, with reference to the technologies under investigation within the plaTform fOr Urinary tract infection diagnostiC evAluatioN (TOUCAN) study.

10.30  Traumatic brain injury POCT