ICMR Plans Single Diagnostic Test to Detect Multiple Infections, Cut Treatment Delays

The agency plans to support Indian manufacturers and research institutions to develop, validate, and scale these diagnostic kits, including rapid production during outbreaks and future pandemics.

The Indian Council of Medical Research (ICMR) has initiated plans to develop a single diagnostic test capable of detecting multiple infections simultaneously, a move aimed at reducing delays in diagnosis and enabling faster, more accurate treatment for patients presenting with serious infectious symptoms.

Patients arriving at hospitals with fever, breathlessness, or severe illness are often subjected to a series of tests for infections such as dengue, influenza, Covid-19, and typhoid. These tests are typically conducted sequentially, with each negative result delaying confirmation of the actual cause and, in some cases, postponing appropriate treatment.

To address this, ICMR is proposing the development of multiplex molecular diagnostic tests that can identify several priority pathogens in a single run. The approach is expected to significantly shorten the time between clinical suspicion and definitive diagnosis, allowing clinicians to make quicker treatment decisions.

At present, hospitals largely depend on symptom-based provisional diagnosis. “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 starts. But if it is negative, testing for other pathogens follows, and this often leads to delay in diagnosis and delay in correct treatment.”

ICMR has noted that this step-by-step testing model not only increases costs but also raises the risk of missing the actual infection, as many diseases present with overlapping symptoms. The proposed single-test framework is designed to screen for multiple pathogens at once, reducing uncertainty during early clinical decision-making.

Diagnostic delays also have broader implications for antimicrobial resistance. While awaiting test results, doctors often initiate empirical broad-spectrum antibiotic therapy. “Empirical antibiotic therapy is started during the provisional diagnosis phase and broadly covers many microorganisms,” Gautam said. “If this continues for long without a positive report, it increases the chances of antimicrobial resistance.”

These concerns align with findings from the ICMR-Antimicrobial Resistance Research & Surveillance Network (AMRSN) annual report 2024, which showed declining effectiveness of several commonly used antibiotics against bacteria frequently isolated in hospitals.

ICMR has linked faster, syndrome-based diagnosis to improved outbreak surveillance, citing lessons from the Covid-19 pandemic, where delayed detection contributed to early silent transmission. The proposed tests will be designed based on India’s disease burden, using national surveillance data.

The agency plans to support Indian manufacturers and research institutions to develop, validate, and scale these diagnostic kits, including rapid production during outbreaks and future pandemics. Proposals for development have been invited, with submissions due by January 25.

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