Parents know the value of the rapid strep test that enables their sick child to begin appropriate treatment in one office visit. In fact, we rarely hear of the serious complications of a strep infection because most cases are diagnosed and treated so quickly.

But what about the many dangerous diseases and antibiotic-resistant infections facing our warfighters? A critical military need is rapid pathogen identification and diagnostic tests that give physicians the crucial head start on potentially deadly bacterial infections, viruses and other biological hazards.

To assess the progress of various pathogen detection technologies in development, the U.S. Army Medical Research and Materiel Command's Telemedicine and Advanced Technology Research Center organized a national project review in May. Sixteen TATRC-funded investigators gave presentations, and six of them demonstrated prototypes of their devices, which were evaluated by a group of approximately 20 Department of Defense scientists to determine their Technology Readiness Level.

It is TATRC's hope that this technology review may help garner funding for advanced development of the most promising projects.

The forum was chaired by TATRC Infectious Disease Portfolio manager Dr. John Carney and Proteomics/Genomics Portfolio manager Dr. Paul Nisson.

According to Nisson, rapid pathogen detection and identification is vitally important in Afghanistan and other theaters due to the many types of unique bacterial strains and other pathogens residing in the soil and dust. This diagnostic capability also is needed in the military's healthcare facilities in Germany and the United States due to the swift rise in the occurrence of multi-drug-resistant wound infections.

Said Nisson, "Classical methods of pathogen detection, where we culture the microorganisms, can take several days to weeks. By the time the diagnosis is made, the soldier has already been moved on to another hospital and the process may need to start over again. That's why we focused this workshop on approaches that quickly detect and identify pathogens."

The projects represented a wide spectrum of technical approaches and applications. Several projects were early in development, such as Dr. David Mosser's microfluidic/gene signature work with waterborne pathogens at the University of Maryland, and Dr. Laura Edsberg's work at Daemen College on a wound status early outcome sensor. Several were at a middle stage, such as the Near-Infrared Raman spectroscopy technology that Dr. Prasad Coorg of Science and Engineering Services, Inc., is applying in a surface hygiene sensor for critical care needs. Seven of the projects were in the relatively advanced category and prototypes were presented. These included:

• A rapid, portable platform using a lens-less charge-coupled device LED light to image and identify pathogens, from Dr. Utkan Demirci of the Harvard-MIT Division of Health Sciences and Technology
• A micro-NMR (nuclear magnetic resonance, or MRI) system for rapid, multiplexed diagnosis of bacterial infections at the point of care, developed by Dr. Sarah Fortune's team at the Harvard School of Public Health
• Integrated Nano-Technologies' (Rochester, N.Y.) Palladium device, a portable system that uses nanotechnology to identify targeted infectious diseases and other biological threats within minutes by detecting PCR-amplified nucleic acid via electrical hybridization
• Resodyn's (Butte, Mont.) field-portable surface plasmon resonance device that can conduct almost immediate testing for viruses or bacteria
• A collaborative program to validate the 3M surface pathogen detector for infection control in hospitals, directed by Dr. Phillip Smith at the University of Nebraska
• 3M Company's (St. Paul, Minn.) wireless sensing system for blood, medical and food safety
• A remote biomedical detector program from QTL Biosystems (New Kensington, Pa.) for sensing the raised cardiac troponin concentrations that indicate a heart attack or heart damage

Presenters commented that the gathering helped them understand the DoD's medical device development process much better. The fruitful discussions were an excellent example of TATRC's role in coordinating collaboration between civilian and military researchers and clinicians to advance care for the nation's service members.

TATRC manages approximately 800 research projects throughout the country. Through an extensive network of partners, TATRC explores models of high-risk and innovative research, and works to translate findings into practical applications.