The University Institute of Medical Microbiology and Virology at Oldenburg Hospital is responsible for detecting infectious pathogens. Institute Director Axel Hamprecht describes the challenges he and his team are currently facing.
Professor Hamprecht, how has the coronavirus changed your work?
Corona has indeed completely changed our everyday lives. Most of the enquiries we currently receive concern the detection of SARS-CoV-2 or the handling of patients. We have quickly set up a test system with which we can detect SARS-CoV-2. We also have to comply with special safety measures for samples from patients with suspected infections, which makes our work much more complex. We have recently changed our working hours - we now work in three separate teams, with no overlaps in terms of time. This is to prevent one employee's infection from paralysing the whole team.
How many tests do you carry out per day?
We are currently carrying out around 50 tests per day, although the number of samples is set to increase.
Can you briefly explain how the test procedure works?
It is a molecular biological test in which we detect nucleic acids of the virus, i.e. the viral genetic material. First we isolate these nucleic acids from the patient sample, then they are amplified in several cycles in a machine. Fluorescent dyes are used to determine whether the test is positive or not. The process is called "real-time reverse transcriptase polymerase chain reaction", or RT-PCR for short.
Your research focuses on the investigation of antibiotic resistance, for example the spread of multi-resistant bacteria, so-called hospital germs. What is the difference between combating viruses and bacteria?
Bacteria are fairly easy to cultivate and can be analysed using a variety of methods. We usually have several antibiotics that are effective. Even with multi-resistant strains, there are usually reserve antibiotics that can be used. Viruses are mainly examined using molecular biological methods; virus cultivation is rarely carried out today and is time-consuming. Unfortunately, we only have very few virustatics, i.e. active substances that inhibit the replication of viruses and that we can use to treat infections. There are a few interesting candidates for coronaviruses - studies are currently being conducted to investigate the extent to which they offer a clinical advantage.
Which direction do you think is particularly promising?
There is Remdesivir, a drug that was originally developed against Ebola and belongs to the class of nucleoside analogues. These are active substances that prevent the genetic material of the virus from being replicated in a cell. It was not very effective against Ebola, but in laboratory studies it has shown good efficacy against SARS-CoV-2. There is also initial clinical data, mainly from individual case reports, which at least look promising. However, we will only know whether Remdesivir works as well as hoped in a few months' time, when data from the larger ongoing studies are available.
How do you rate the chances of finding a virus inhibitor against the coronavirus in the coming months?
I'm currently placing the greatest hope in Remdesivir, because development is already quite advanced and it's not a completely new drug. But I doubt that it will be available to many patients outside of trials in the near future. There are also other trials with already known drugs that were actually developed for other medical indications. This is known as "drug repurposing", i.e. the use of a known active ingredient for a different purpose. In laboratory tests, for example, chloroquine, an antimalarial drug, or teicoplanin, an antibiotic, are effective against coronaviruses. However, it must be emphasised: The extent to which these substances really provide a therapeutic benefit for patients with COVID-19 is still unclear.
Interview with: Ute Kehse
