Precision Medicine for Infectious Disease: The Next Frontier Beyond Oncology

What precision medicine means and why it has meant oncology

Precision medicine matches the right treatment to the right patient based on the specific biology of their disease, rather than a one-size-fits-all protocol. For two decades, that promise has been realized most visibly in cancer care. Genomic sequencing of tumors, biomarker-guided therapy selection, and targeted treatments have made oncology the proving ground for personalized medicine.

That progress was built on a simple foundation: the ability to read the molecular signature of a disease and act on it. Cancer patients have come to expect a diagnosis that carries genuine depth — not just what the disease is, but how it should be treated for them specifically.

Why infectious disease has been left behind

Infectious disease accounts for an enormous share of global morbidity and healthcare cost, yet it has largely missed the precision-medicine wave. The reason is diagnostic. Much of infectious disease care still depends on culture-based testing. These methods are slow, limited in the range of pathogens they detect, and require additional testing to answer the question that increasingly determines outcomes: which drugs will actually work?

The stakes are not abstract. Antimicrobial resistance (AMR) was directly responsible for an estimated 1.27 million deaths worldwide in 2019, and was associated with nearly 5 million — placing it among the leading causes of death globally, ahead of HIV/AIDS and malaria [1]. Every empiric prescription written without resistance information is a bet against that trend.

How next-generation sequencing brings precision to infectious disease

The technologies that transformed oncology are now mature enough to do the same for infections. Next-generation sequencing can read the genetic material in a clinical sample directly, identifying pathogens that traditional culture-based testing misses. Layered with machine learning trained on large, curated genomic references, sequencing can also predict drug resistance — turning a diagnosis into a treatment-guiding result.

At Biotia, we believe this combination delivers the core promise of precision medicine to infectious disease: the right diagnosis, at the right time, to guide the right treatment for each individual patient.

The BIOTIA-ID Urine Test: precision diagnostics for UTIs in practice

Urinary tract infections are among the most common bacterial infections in the world, affecting a vast number of people every year [2]. They are also a clear illustration of where conventional diagnostics fall short and what precision infectious disease testing can look like instead.

The limits of culture-based testing

Standard urine culture has changed little in decades, with technology originating in the 1800s. It misses a meaningful proportion of pathogens and offers no insight into a patient's antimicrobial resistance profile without a separate test. The result is empiric prescribing: clinicians treat using their best judgement and population-level drug resistance data, rather than on personalized evidence, which contributes to treatment failures and to the broader spread of resistance.

Broader pathogen detection through sequencing and machine learning

The BIOTIA-ID Urine Test, and other similar clinical metagenomic tests, uses next-generation sequencing and machine learning to identify a far broader range of pathogens from a clinical urine specimen than culture typically detects, providing a more complete picture of what is actually present. This approach also allows for identification of species that are slow-growing or don't grow in culture.

Strain-level antimicrobial resistance profiling

In the same workflow, the test is designed to profile drug resistance at the strain level including characterization of drug resistance genes. That pairing — what the pathogen is and what antimicrobial treatment it will respond to — is what allows clinicians to move away from empiric prescribing and toward personalized treatment decisions: getting patients to an effective antibiotic sooner while reducing reliance on broad-spectrum agents that drive further resistance.

Independently validated: two consecutive CAMDA wins

The strength of the underlying bioinformatics has been validated independently. Biotia's antimicrobial resistance prediction platform (BIOTIA-DX Resistance) achieved the highest prediction accuracy in the international CAMDA Antimicrobial Resistance Challenge in both 2025 and 2026, outperforming some of the strongest computational teams in the world on resistance profiling from metagenomic data, across two different datasets [3, 4]. BIOTIA-DX Resistance is integrated into the BIOTIA-ID Urine Test, which is approved under the New York State Clinical Laboratory Evaluation Program (CLEP) and available for clinical use across all 50 US states [3].

Beyond UTIs: expanding the precision diagnostics platform

UTIs are a starting point, not the destination. Biotia is actively extending its precision diagnostics platform across a range of infectious disease contexts.

Orthopedic and musculoskeletal infection

In collaboration with Hospital for Special Surgery, ranked the world's leading academic medical center for musculoskeletal health, Biotia is applying clinical metagenomics to joint infections, where accurate, early pathogen identification is critical to patient outcomes and where conventional diagnosis is notoriously difficult [5]. Research and development for the BIOTIA-ID Joint Fluid Test is underway.

Decentralized and remote infectious disease diagnostics — including space

The platform is also being validated for remote and decentralized settings — including in space. As part of a three-way effort with the Korean pharmaceutical company Boryung and Dr. Charles Chiu of UC San Francisco, Biotia is advancing diagnostic technologies built to sequence clinical samples under the extreme demands of spaceflight through the Humans in Space Challenge. This work has direct relevance to remote healthcare on Earth, particularly given the resource constraints of spaceflight [6].

The future of precision infectious disease medicine

As sequencing costs continue to fall and AI-driven interpretation grows more sophisticated, the gap between cancer care and infectious disease care narrows. We see a near-term future in which every infectious disease diagnosis carries the same depth of insight that cancer patients have come to expect — a diagnosis that does not just vaguely sketch out the problem, but provides personal insight into the problem and points to the solution.