1. Syndromic Testing –
A New Take on
Diagnosing
Infectious Diseases
Emerging Tech Webinar
September 2023

2. 2 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Moderator and Speakers
www.bisresearch.com
Bruno Miguel Taveira Vaz
Country Lead
BD
Amr Farid
Business Development
LabCorp
Prateeksha Singh
Lead Analyst
BIS Research Inc.
(Moderator)
Riya Gupta
Research Analyst
BIS Research Inc.

3. 3 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Agenda
www.bisresearch.com
Introduction
New Standard of Care in the Treatment
of Infectious Diseases and Syndromic
Testing
Major Factors Driving the Growth of the
Syndromic Testing Market
Syndromic Testing
Market Growth
Major Players in the Syndromic
Testing Market Ecosystem
Opportunities of Syndromic Testing
Q&A Session
Use of NGS Metagenomics in
Acute Care Syndromic
Testing

4. Bruno Miguel
Taveira Vaz
Country Lead
BD
Key Speaker

5. Syndromic
diagnostic testing -
new standard of
care in the
treatment of
infectious diseases

6. Disclosure

7. Agenda

8. The need

9. The need
LABORATORY DIAGNOSIS HISTORIC ALLY PERFORMED
USING A “MIXED B AG ” APPROACH

10. Laboratory diagnosis
GASTROENTERITIS
Rapid testing is vital
Appropriate treatment for
critical patients
Prevent the spread of
gastroenteritis through isolation
measures

11. Laboratory diagnosis
GASTROENTERITIS
Conventional diagnostics techniques
Culture
Antigen
detection
Microscopy
Multiple steps Up to 3 days for result

12. Laboratory diagnosis
GASTROENTERITIS
Additional
testing
Gram staining
Catalase
Hippurate
Incubation
42 ºC
37 ºC
Microaerophilic
48 h
Culture
Skirrow, Butzler,
Preston
CCDA
Methylene
blue
stool
staining
Sensitivity
Specificity
Campylobacter spp. isolation

13. What if we could simplify infectious
diseases testing with…..
Results up to
3 h or less?
Reduced hands-
on time?
Greater
sensitivity and
specificity?
Flexibility for a
targeted
diagnosis?

14. The Solutions

15. The Solutions
Advances in molecular diagnostics allow for a targeted diagnosis of
infectious diseases
Better Clinical
Performance
Direct Pathogen
Detection
Reduced Hands-on
Time
Reduced Time To
Detection

16. The Proposals

17. The Proposals

18. The Value

19. Faster…Bigger…
must be
BETTER, right?

20. The value
C ASE #1

21. The value
C ASE #1, CONTINUED

22. The value
SYNDROMIC PANELS:
ADVANTAGES
SYNDROMIC PANELS:
LIMITATIONS

23. Summary

24. References

25. Thank you
brunotaveira@hotmail.com

26. Amr Farid
Business
Development
LabCorp
Key Speaker

27. Empowering Healthcare:
Metagenomics NGS in Acute Syndromic Testing

28. Objectives:
- Overview
- Infectious Diseases Diagnostics
- Metagenomics Next Generation Sequencing (mNGS)
- Key Applications & Implementing of Clinical (mNGS)
- Summary

29. Overview:
- Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or
fungi; the diseases can be spread, directly or indirectly, from one person to another.

30. Infectious Diseases Diagnostics:
- The global burden of antimicrobial resistance continues to rise.1
- 5 Priority bacterial pathogens account for >70% of the AMR deaths
- The judicious use of antimicrobials is of utmost importance.
- Novel unknown Infections and mutation, outbreaks.
1.Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-
6736(21)02724-0. Epub 2022 Jan 19. Erratum in:
Lancet. 2022 Oct 1;400(10358):1102. PMID: 35065702; PMCID: PMC8841637.

31. Infectious Diseases Diagnostics: A major threat to global health
- Drug-resistant infections affect the lives of billions worldwide.2
2.Ramanan Laxminarayan et al. Access to effective antimicrobials: a worldwide challenge. Lancet. 2016; 387: 168-175 / https://www.reactgroup.org/news-and-views/news-and-opinions/year2020/new-react-film-
children-at-risk-the-threat-of-antibiotic-resistance/; 2. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet 2022
https://www.sciencedirect.com/science/article/pii/S0140673621027240?via%3Dihub; 3. https://www.worldbank.org/en/topic/health/publication/drug-resistant-infections-a-threat-to-our-economic-future

32. Infectious Diseases Diagnostics Methods:
- Current diagnostic methods:
- One at a time or multiple known pathogens.

33. What is Metagenomics Next Generation Sequencing:
- Metagenomics (mNGS) is the discipline that refers to the sequencing of all
nucleic acid material present within specimen to recover clinically relevant
microbial information.

34. What is Metagenomics Next Generation Sequencing: Historical overview
3.Metagenomics timeline and milestones. Timeline showing advances in microbial communities studies from Leeuwenhoek to NGS (Ottman et al., 2012; Yarza et al., 2014).

35. What is Metagenomics Next Generation Sequencing (Types):
- Targeted amplicons rRNA 16S
- Shotgun sequencing
The reference: "3.Chiu CY, Miller SA. Clinical metagenomics. Nat Rev Genet. 2019 Jun;20(6):341-355. doi: 10.1038/s41576-
019-0113-7. PMID: 30918369; PMCID: PMC6858796."

36. Key Applications & Implementing of Clinical (mNGS)
- General Application
- Clinical Diagnostics
- Epidemiology
- Animal Health
- Food Safety
- Drug discovery
- Environmental

37. Key Applications & Implementing of Clinical (mNGS)
- Clinical application:
- Screening and discovery of novel genes/enzymes
- New species discovery
- Pathogen Dx
- Pharmacogenomics
- Antibiotic resistance

38. Key Applications & Implementing of Clinical (mNGS)
- To implement NGS in routine diagnostics, several adjustments in the laboratory workflows are required.
1- The wet laboratory
(nucleic acid extraction, library preparation, sequencing)
2- The bioinformatics
(analyses of the sequence data and translating them into easy to understand reports)

39. Summary
- Metagenomics has broad applications in various industries.
- We anticipate that the use of mNGS in medical microbiology laboratories will further increase over the
next few years, for the characterisation and surveillance of pathogens, the investigation of outbreaks,
infection prevention and the detection of novel resistance genes.
- Whole Genome Shotgun Sequencing is a powerful tool to study microbiome and understanding host-
pathogen interactions.

40. References:
- Dumkow LE, Worden LJ, Rao SN. Syndromic diagnostic testing: a new way to approach
patient care in the treatment of infectious diseases. J Antimicrob Chemother. 2021 Sep
23;76(Suppl 3):iii4-iii11. doi: 10.1093/jac/dkab245. PMID: 34555157; PMCID: PMC8460095.
- Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in
2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-
6736(21)02724-0. Epub 2022 Jan 19. Erratum in: Lancet. 2022 Oct 1;400(10358):1102.
PMID: 35065702; PMCID: PMC8841637.
- Metagenomics timeline and milestones. Timeline showing advances in microbial communities
studies from Leeuwenhoek to NGS (Ottman et al., 2012; Yarza et al., 2014).
- Chiu CY, Miller SA. Clinical metagenomics. Nat Rev Genet. 2019 Jun;20(6):341-355. doi:
10.1038/s41576-019-0113-7. PMID: 30918369; PMCID: PMC6858796.

41. Riya Gupta
Research Analyst
BIS Research Inc.
Key Speaker

42. Syndromic Testing:
Trends and Key
Market
Developments

43. 43 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
1.28 1.51 1.94
3.25
2022 2024 2027 2033
$Billion
North America Europe Asia Pacific Latin America
CAGR (2023-2033): 9.43%
Regional Market Landscape
Current market adoption rates across regions indicate a high-growth market
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Source: BIS Research Analysis Source: BIS Research Analysis
North America
Europe
Asia Pacific
Latin America
Rest of the
World
0.00%
40.00%
80.00%
0.00% 7.00% 14.00%

44. 44 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Testing Landscape
Syndromic Tests Available for Various Disease Types
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56.29%
20.65%
15.89%
4.58%
2.59%
2022
Respiratory Diseases
Gastrointestinal Diseases
Genitourinary Diseases
Tropical Diseases
Others
56.20%
22.87%
11.98%
4.15%
4.80%
2033
Source: BIS Research Analysis
As of 2022, the global acute care syndromic testing market (by disease type) was dominated by the respiratory
diseases segment, holding a 56.29% market share. Additionally, the revenue of the respiratory diseases
segment is anticipated to increase to $4.74 billion by 2033, holding a 56.20% market share in 2033.
Infectious diseases are of many types and can
most easily be sorted by the type of disease
they cause. Over the last few decades with
the advent of numerous outbreaks such as
the Spanish Flu in 1918, SARS in 2002, and
lately the advent of COVID-19 in 2019, the
world has witnessed many medical
achievements, and due to this, most infectious
diseases are now curable. However, there are
still numerous infectious diseases left that still
do not have a cure and thus are a great
burden to the economy.
Other Diseases include central nervous
system-based infections, such as those
caused by meningitis and encephalitis, and
blood culture-based infections, such as
sepsis.

45. 45 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Market Shares > 6%
Market Shares in the Range of 4%-6%
Market Shares < 4%
Leading Players in the Market
The market is dominated by big players
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Source: BIS Research Analysis

46. Syndromic Testing
Market Dynamics

47. 47 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Factors Propelling the Demand for Syndromic Testing
The Rising Population and Global Temperature are the Key Catalysts for the Increase of Infectious Diseases
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Increasing Incidence of
Infectious Diseases
Early Diagnosis with
Syndromic Testing
Reduced Use of Antibiotics
because of Syndromic Testing
+2 Bn
World population has been steadily
rising and is further expected to
increase by nearly 2 billion people in
the next 30 years
30%
It is estimated that antibiotic resistance
caused 4.95 million deaths in 2019.
antibiotic prescriptions could be
reduced by 30% with the use of
syndromic testing
~$3,000
According to BioFire Diagnostics, using
syndromic testing panels can save
hospitals expenses by about $3,000 per
patient in overall hospital costs for
sepsis alone

48. 48 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Opportunities of Syndromic Testing
Decreasing Time of Diagnosis Leads to Lower Symptoms and Lower Use of Antibiotics
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Reduction in Antibiotics Use with Syndromic Testing
Time of Diagnosis vs. Disease Effect
13% Reduction
in Antibiotic
Therapy
Duration
30% Reduction
in Antibiotic
Prescriptions
A Fewer Day in
the Median
Antimicrobial
Duration in Adult
Influenza
Patients
Source: BIS Research Analysis Source: QIAGEN N.V. Company Website
Time of Diagnosis
with Single Plex
Panels
Onset of Symptoms
Time of Diagnosis
with Syndromic
Panels
Early Intervention
After Symptoms
Disease Effect
Time
of
Diagnosis

49. 49 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
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51. 51 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
Syndromic Testing – A New Take on Diagnosing
Infectious Diseases
Speaker Contact Information
Bruno Miguel Taveira Vaz
Reach out to him at
brunotaveira@hotmail.com
Amr Farid
Reach out to him at
amr.alawi.a@gmail.com
www.bisresearch.com

52. 52 Syndromic Testing – A New Take on Diagnosing Infectious Diseases
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YOU
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