People are very familiar with antimicrobials that are used for the treatment of infections. The three major points in the proper use of antimicrobials are the following, and there are various issues to be addressed.
The first is prescribing antimicrobials properly. An effective way of achieving this is to determine the type of bacteria infecting the patient and which antimicrobial will have the best efficacy against it. However, it is currently difficult to prescribe antimicrobials based on testing results at the first consultation, because it can take several days from testing to obtaining the results. The second is not using antimicrobials unnecessarily. They may be used unnecessarily in some cases when the patient is not actually infected, because proper testing cannot be provided in a timely manner. The third is appropriate use by patients. There have been cases when, based on their own judgment, patients stop taking prescribed antimicrobials before the end of the course and use the remaining medication on another occasion.
The improper use of antimicrobials is one of the main causes of AMR. If an antimicrobial is used improperly, it will not be completely eradicated and may survive and become resistant to antimicrobials. The proliferation of drug-resistant bacteria will make antimicrobials much less effective, making it difficult to treat infections that would otherwise be mild and easy to recover from, and they may become severe or even be fatal.
It has been estimated that 10 million people will die annually due to AMR in 2050.1 This exceeds the number of deaths due to cancer, and the WHO and various other organizations have designated AMR as a social challenge that should be addressed on a global level.
1 Source: Action Plan. https://amr.ncgm.go.jp/medics/2-4.html (Reference 2022-11-11)

To combat AMR, Sysmex is focusing on realizing rapid testing that will aid decisions on proper medication. Through urinalysis instruments that detect bacteria, white blood cells, and other substances in urine, Sysmex provides support for the diagnosis of urinary tract infections, and this contributes to the provision of proper treatment by reducing the unnecessary use of antimicrobials.
In addition, as a new initiative, together with a Group company, Sysmex is working on the establishment of testing technology for rapidly determining which antimicrobials will be effective (Antimicrobial Susceptibility Testing, AST), as well as product development based on it. The company is Astrego,
2 which was established in Uppsala, Sweden. This company has proprietary technology capable of rapidly performing antimicrobial drug susceptibility testing, which is used to examine the effectiveness of antimicrobials against bacteria detected in urine samples. Since its establishment in 2017, this company has been going ahead with commercial development.
Among its management goals, Sysmex has set “becoming a solution provider contributing to the advancement of primary care diagnostics” as a positioning goal, and has been working on leveraging diagnosis technology and IT cultivated through its in vitro diagnostics business, and providing solutions that contribute to improving access to healthcare.
In view of these circumstances, the two companies agreed to Sysmex investing in Astrego in December 2019, and since then have been working together on product development. With the objective of further strengthening synergies, Astrego became a Sysmex Group company in May 2022.
2 With Sysmex making Astrego a wholly-owned subsidiary in May 2022, the company’s name was changed from Astrego Diagnostics AB to Sysmex Astrego AB.
What is the partnership between Sysmex and Astrego, how far they have come, and what are their aspirations for the AMR response? From here we present a conversation between Tetsuji Umeno, Director of the Primary Care Business Development Department of HUP Business Division and Mikael Olsson, CEO of Sysmex Astrego AB.