PROJECT SUMMARY
Neonatal septicemia is a life-threatening disease that affects roughly 2 out of every 1,000 live births in the US,
where 25-30% do not survive. Caused by an infection of the newborn bloodstream either at the time of birth or
soon after, the disease’s initial clinical manifestations are often non-specific, variable, at times subtle, and often
common to signs of stress. Thus a core requirement to both to rule-in a bloodstream infection (BSI) and to rule-
out a BSI is microbiological evidence; which is currently only possible through blood-cultures. Cultures,
however, display two major weaknesses which, crucial to outcome, delay the administration of the proper
antimicrobials: (1) Long turnaround time of days and (2) high prevalence of false-negative results due to
maternal antibiotics and a reduced input blood volume. As time is of essence for optimal outcomes, treatment
is generally initiated prior to microbial diagnosis with a cocktail of broad spectrum (i.e. not personalized)
antimicrobials, leaving the majority of patients treated inappropriately and those without the disease treated
unnecessarily. It is therefore critical to advance innovative diagnostic approaches which do not rely on
culturing in order to facilitate a transition to an evidence-based decision making process as soon as feasible.
Having met our and exceeded our Phase I Specific Aims, this Phase II proposal focuses on development of a
fully-automated neonatal pathogen identification (Neo/PID) platform enabling the ‘hands-free’ identification
of the most clinically prevalent pathogens directly from phlebotomy specimens, in roughly 2 hours, without
the need to culture. The Phase II proposed diagnostic device is expected to have profound impact, both by
improving outcomes by providing a means to develop an evidence driven first-line intervention, and likewise
by reducing the use of excessive and unnecessary antimicrobials.
In order to succeed in this endeavor, we have assembled a top-notch team including experts in assay
development, artificial nucleic acids, and the implementation of automated diagnostics. Additionally, we have
enlisted key advisors in clinical microbiology, surface chemistry, and pathology as well as successful
entrepreneurs experienced in the commercialization of diagnostic devices. Together, we will build upon our
impressive Phase I results and develop an automated platform, dedicated to neonatal BSIs, culminating in a
performance assessment study with clinical specimens. Having achieved our Specific Aims, we will develop
deployable instrumentation/consumables and validate our diagnostic in preparation for the pivotal clinical
trial.