In conversation with Geethanjali Radhakrishnan, Founder, CEO and Managing Director at Adiuvo Diagnostics

What’s your backstory and how did you come up with the idea?

During Adiuvo’s initial days, we were incubated at Villgro, and we were trying to identify a problem statement in the healthcare space. We were advised to approach physicians to observe firsthand the problems people face and solve an unmet need. That is when I met Dr. Ayush Gupta from DY Patil hospital in Pune, Maharashtra. Dr. Gupta caters to over 100 patients with skin and soft tissue infections on a daily basis. I observed that many of these patients come from rural areas to get treated at a multi-speciality hospital, because the infection gets to a critical stage due to a lack of proper screening and treatment. Very often, in such critical cases, surgical intervention is the only option to help the wound to close. This problem is further exacerbated when the doctors are inexperienced, which is often the case in government hospitals in rural settings.

Moreover, the absence of a definite diagnosis of the infection leads to both over prescription of medicine and prescription of the incorrect medicine, very often an antibiotic or antifungal drug. This, in turn, contributes to the ever growing global health threat of antibiotic and antifungal resistance.

Thus after realising this unmet need, together with my team, we developed Illuminate. This is a rapid, affordable screening device which can detect and also classify bacterial and fungal infections in wounds.

Tell us more about the technology.

Adiuvo Diagnostics has developed a novel imaging device that captures multispectral autofluorescence images and uses machine learning algorithms on the obtained spectral images to help with label free rapid diagnosis.  Multispectral auto-fluorescence imaging leverages the tissues’ and microbiome’s native fluorescence and aids in label free detection. Biomarkers like NADH, Flavin, Porphyrin, Di-tyrosine linkages, Chitin, collagen etc. have a characteristic emission when excited with various wavelengths of light. Analysis of these spectral images at various emission bands and applying machine learning/deep learning techniques on these images can be effectively used in label free detection of pathogens to antibiotic susceptibility testing to even diagnosis of cancer. ‘Illuminate®’ is one such novel screening device that can non-invasively detect and classify pathogens on wounds in under two minutes as opposed to the standard culture method which takes up to a week for a definitive result. Illuminate® makes treatment affordable and ensures that the first-line treatment is accurate.

How are you doing today, in terms of the impact of your work?

Adiuvo is addressing the global problem of acute, chronic, and traumatic wounds which affects more than 420 million people. 

These wounds can be classified into three major types, depending on the cause: (i) diabetic foot ulcer (ii) surgery associated infection and (iii) burn-related wounds.

All of these wounds are prone to getting infected and the infection is often caught when visible symptoms appear, such as formation of pus or if the patient has a fever. Thus, there is an urgent need for infected wounds to be classified and identified to decide on a proper course of action.

Currently, when an open wound is presented, a culture swab is taken, and the culture report takes 3-7 days. Moreover, the sampling is heavily dependent on the skill of the nurse/technician, and incorrect sample collection can result in a false negative. In fact, studies have shown wound infection is correctly identified only in 57% instances by visual inspection, both to due to expertise of the doctor and sampling error.

Our device Illuminate can help in all wound cases by identifying the region of infection, and type and burden of infection. This in turn can improve overall treatment outcomes in the following ways:

• Improve accuracy of sampling. Also, as reported in a study, a mixed infection may go undetected by a single swab, whereas image-guided sample collection overcomes this problem.
• Offer surgeons, who currently rely on visual inspection, an evidence-based approach to remove infected tissues
• Enable nurses to clean wounds more effectively, helping close the wound faster.
• Allows for monitoring the daily progress of wound healing, which is not possible with a culture report
• Allows doctors to prescribe the right medication, thereby minimizing the incidences of incorrect antibiotic and antifungal drugs.

Illuminate is currently being used in over 10 hospitals across India, and a recent case study** report highlights the utility of this imaging device in guiding wound treatment. The full case study can be accessed here.

Going ahead, the team of Adiuvo is using the same core technology to develop more advanced wound analytics (eg:, how deep is the wound), and an antibiotic susceptibility testing device.

** Shah BM, Ganvir D, Sharma YK, Mirza SB, Misra RN, Kothari P, et al. Utility of a real-time fluorescence imaging device in guiding antibiotic treatment in superficial skin infections. Indian J Dermatol Venereol Leprol 2020;1-6.

How was Adiuvo’s journey funded?

We were incubated by Villgro Innovations Foundations and around the same time we received our BIG BIRAC Grant along with ASME-ISHOW award. The incubation and support from Villgro, a social impact organisation and Venture centre through BIG grants had really helped us establishing the early proof of concept.

Villgro also provided us with grant support to accelerate the PoC. Post which we raised a seed fund round with Menterra Ventures, a deep tech impact investor. Simultaneously, we also received SBIRI grant from BIRAC,GoI.

 Now we raised additional funding Series-A funding with both Menterra and Lesing Artha limited to create a significant impact into wound care with early screening and diagnostics. This will also help us venture into markets outside India.

What do you think were the key reasons for the success of Adiuvo?

Early access to mentors, was one of the significant factors. We were mentored extensively by Villgro Innovation Foundations ( CTO Dr.Arun Venkatesan) through their technical assistance program, and we had access to analytical instruments and Microbial facility through Venture Center and Golden Jubilee Biopark for Woman. As we are also working into AMR, we received assistance from CCamp as well, which was key in product development and understanding various regulatory framework. Brainstorming with various stakeholder, from mentors to customer and technical experts helped us learn through their years of experience and towards course correction.

 We also onboarded many key opinion leaders early on and support from Prof.M. Viswanathan Diabetes Research Centre, DY Patil Hospital Pune, GMERS Medical College and Hospital , Dr RK Clinic aided us to pilot this novel, first of its kind device into various clinical settings and fine tune to exactly meet the needs of Indian patient population.

Our true success lies in delivering the solution even to the remotest of the location with no access to wound care and also in taking the device on global front.