Rapid test for antimicrobial resistance in infections launched in Guntur
A rapid diagnostic test for detecting antimicrobial resistance (AMR) in clinical infections has been launched in India, marking an important step in the country's fight against drug-resistant pathogens.
The test is based on CRISPR technology and loop-mediated isothermal amplification (LAMP), developed by CrisprBits — a Bengaluru-based biotechnology startup.
The platform (PathCrisp-AMRDetect) can detect resistance genes in bacterial samples — specifically targeting NDM (New Delhi Metallo-beta-lactamase) resistance genes, which confer resistance to last-resort carbapenem antibiotics.
Results are delivered within two hours — compared to the standard 48–72 hours for conventional culture-based AMR testing — enabling timely, targeted antibiotic prescription.
The test requires no specialised thermocycler equipment (operates at a constant temperature), making it deployable in resource-limited hospital settings.
Future expansion plans include testing directly from blood, urine, and pus samples, and adapting for ICU settings and low-resource environments through lyophilised (freeze-dried) reagents.
India reported over one million AMR-associated deaths in 2019, making it one of the world's worst-affected countries.
Antimicrobial Resistance (AMR) — The Global Health Crisis
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve mechanisms to survive exposure to medicines designed to kill them. It is often called a "silent pandemic" — it kills without dramatic outbreaks but steadily erodes the effectiveness of the antibiotics that underpin modern medicine.
Key Details
- Global burden: AMR caused an estimated 1.27 million direct deaths globally in 2019, and was associated with 4.95 million deaths (Lancet, 2022)
- India's burden: India bears one of the highest AMR burdens globally — over 1 million AMR-related deaths in 2019; high antibiotic use in agriculture and human medicine drives resistance
- Superbugs: Multi-drug resistant (MDR) and extensively drug-resistant (XDR) organisms — including Klebsiella pneumoniae, Acinetobacter baumannii, E. coli — are increasingly common in Indian hospitals
- NDM-1 (New Delhi Metallo-beta-lactamase): A resistance gene first identified in a patient in India in 2009; confers resistance to carbapenems — the last line of antibiotics for severe infections; has since spread globally
- Key drivers of AMR in India: Over-the-counter antibiotic availability, irrational prescribing, use of antibiotics in livestock (as growth promoters), inadequate infection control in hospitals, and weak wastewater treatment
- Economic cost: The World Bank projects that AMR could cost the global economy $1 trillion/year by 2050 and push 28 million people into poverty
The rapid AMR test directly addresses a critical gap in India's AMR management — the lack of fast, affordable, point-of-care diagnostics that enable doctors to prescribe the right antibiotic quickly, reducing both treatment failure and the selection pressure that drives further resistance.
CRISPR-Based Diagnostics — Technology Explained
CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) is best known as a gene-editing tool, but it also has powerful diagnostic applications — CRISPR-based diagnostics exploit the precise DNA-recognition capability of CRISPR enzymes to detect specific genetic sequences in patient samples.
Key Details
- How it works: A guide RNA directs the CRISPR enzyme (typically Cas12 or Cas13) to a specific DNA or RNA sequence — when the target is found, the enzyme is activated and produces a detectable signal
- LAMP (Loop-Mediated Isothermal Amplification): A DNA amplification technique that, unlike PCR, operates at a constant temperature — eliminating the need for expensive thermocycling equipment; faster, simpler, more field-deployable
- PathCrisp specifics: Combines LAMP (for DNA amplification) with CRISPR detection — the integrated assay delivers results in two hours, with 100% concordance with gold-standard PCR-Sanger sequencing in clinical validation (49 bacterial samples tested)
- Advantage over culture-based AMR testing: Traditional antimicrobial susceptibility testing (AST) by culturing bacteria takes 48–72 hours — during which patients receive empirical (guesswork) antibiotics, increasing resistance risk and mortality
- India's diagnostic innovation ecosystem: Bengaluru, Hyderabad, and Pune are emerging as hubs for point-of-care diagnostic startups, supported by the Ayushman Bharat Digital Mission, DBT (Department of Biotechnology), and BIRAC (Biotechnology Industry Research Assistance Council)
CRISPR-LAMP diagnostics represent a technological leap — combining genetic precision with operational simplicity. The PathCrisp launch demonstrates India's capacity to develop globally relevant, affordable diagnostics domestically rather than importing them.
India's Policy Response to AMR
India has developed a structured policy architecture to combat AMR, reflecting both the domestic burden and international commitments under WHO's Global Action Plan on AMR (2015).
Key Details
- National Action Plan on AMR (NAP-AMR), 2017–21: India's first coordinated plan — five objectives: awareness, surveillance, infection prevention, optimised antibiotic use, research & innovation
- NAP-AMR 2.0 (2024–2030): Updated plan with greater emphasis on One Health approach — integrating human, animal, and environmental health in AMR combat
- ICMR AMR Surveillance Network (AMR-SN): 30 hospitals initially, expanded to 50+ medical colleges in 27 states monitoring resistance patterns in major pathogens
- One Health approach: Recognises that human health, animal health, and environmental health are interconnected — especially relevant for AMR where agricultural antibiotic use drives human infection resistance
- Schedule H1 drugs: DCGI regulation requiring prescription for 24 critical antibiotics — an attempt to curb over-the-counter sale, though enforcement remains weak
- Key gap: India lacks rapid, affordable point-of-care AMR diagnostics in most of its 25,000+ primary health centres — making this launch directly relevant to closing the last-mile diagnostic gap
The rapid AMR test aligns precisely with the surveillance and "optimised antibiotic use" pillars of NAP-AMR — the ability to detect resistance quickly enables evidence-based prescribing, which is central to AMR stewardship.
- Technology: CrisprBits PathCrisp-AMRDetect (CRISPR + LAMP combination)
- Developer: CrisprBits Pvt. Ltd., Bengaluru
- Target pathogen: NDM (New Delhi Metallo-beta-lactamase) — carbapenem-resistant bacteria
- Test turnaround time: 2 hours (vs. 48–72 hours for conventional culture-based testing)
- Equipment needed: Constant-temperature incubator only (no thermocycler)
- Clinical validation: 100% concordance with PCR-Sanger sequencing across 49 clinical samples
- India's AMR deaths (2019): Over 1 million AMR-associated deaths
- Global AMR deaths (2019): ~1.27 million direct deaths; ~4.95 million associated (Lancet, 2022)
- NDM-1 discovery: 2009, India — resistance gene now spread globally
- NAP-AMR: National Action Plan on AMR — launched 2017; updated as NAP-AMR 2.0 (2024–2030)
- ICMR AMR surveillance: 50+ medical colleges, 27 states
- WHO Global Action Plan on AMR: Adopted 2015, guides national responses
- Projected global AMR economic cost: $1 trillion/year by 2050 (World Bank)