In a major push to speed up diagnosis of serious infections, the Indian Council of Medical Research (ICMR) has initiated efforts to develop a single diagnostic test capable of detecting multiple infections simultaneously. Experts believe the move could not only reduce delays in starting the right treatment but also curb the excessive use of broad-spectrum antibiotics, a key driver of antimicrobial resistance (AMR).
Current Testing Model Causes Delays
Patients arriving at hospitals with symptoms such as fever, breathlessness, or severe illness are often subjected to a series of individual tests—for dengue, influenza, Covid-19, typhoid, and other infections. Clinicians typically rule out diseases one by one. However, each negative result delays diagnosis and appropriate treatment, sometimes with serious clinical consequences.
To address this challenge, ICMR has outlined a plan to develop multiplex molecular diagnostic tests that can screen for multiple pathogens in a single run, significantly reducing diagnostic turnaround time and improving clinical decision-making.
Symptom-Based Diagnosis Has Limitations
At present, most hospitals rely on symptom-based provisional diagnosis to guide testing. “Once a patient comes to a hospital with a suspected infectious cause, samples are sent for testing based on the provisional diagnosis,” said Dr Hitender Gautam, Professor of Microbiology at AIIMS. “If the test is positive, a definitive diagnosis is made and treatment begins. However, if it is negative, testing for other pathogens follows—and this often delays both diagnosis and correct treatment.” ICMR has flagged that this stepwise testing approach increases costs and risks missing the actual cause, as many infectious diseases present with overlapping clinical symptoms.
Single-Test Approach Could Improve Outcomes
The proposed single-test diagnostic model aims to screen for priority pathogens at once, allowing clinicians to move more quickly from suspicion to confirmation. By shortening diagnostic timelines, the approach could lead to earlier, targeted treatment, improving patient outcomes while easing pressure on healthcare systems.
Reducing Antibiotic Misuse and Resistance
Diagnostic delays also have serious downstream effects on antibiotic use. While awaiting test results, clinicians often initiate empirical broad-spectrum antibiotic therapy. “Empirical antibiotic therapy is started during the provisional diagnosis phase and broadly covers many microorganisms,” Dr Gautam explained. “If this continues for long without a positive report, it increases the chances of antimicrobial resistance.” These concerns are echoed in the ICMR–Antimicrobial Resistance Research & Surveillance Network (AMRSN) Annual Report 2024, which shows that several commonly used antibiotics are rapidly losing effectiveness against bacteria frequently isolated in hospitals.
Faster Diagnosis Could Strengthen Surveillance
Faster, syndrome-based diagnosis could help reverse this trend by enabling an early shift to targeted therapy, which carries a significantly lower risk of resistance. ICMR has also linked quicker diagnosis to stronger outbreak surveillance, drawing lessons from the Covid-19 pandemic, where delayed detection contributed to early silent transmission.
India-Focused Kits and Industry Collaboration
The proposed diagnostic tests will be tailored to India’s disease burden, using insights from national surveillance data. ICMR plans to support Indian manufacturers and research institutions in developing, validating, and scaling up these kits. As reported by factnewsindia.com, the strategy also includes provisions for rapid manufacturing during outbreaks and future pandemics. Proposals for developing these multiplex diagnostic tests are due by January 25.