Sepsis - a growing threat to public health

Sepsis or, more commonly, blood poisoning is caused by microorganisms entering the blood stream. This causes the immune system to “over-react” to fight the infection, but instead the reaction itself harms the body by causing massive inflammation and leaky blood vessels. If not treated in time, sepsis can lead to septic shock with organ failure and death. A broad range of bacteria and fungi may can cause sepsis. However, less than 30 strains of bacteria and fungi are believed fuel more than 80 percent of the clinically relevant sepsis cases. Antimicrobial therapy is a key element in treatment – in severe sepsis, the survival rate is between 80 and ten percent depending on if the patient receive the right treatment within the first 24 hours or not.

Slow diagnostics leads to an overuse of broad spectrum antibiotics

Current methods require a 24-hour cultivation of the patient’s blood before the infecting agent can be identified and another 24-48 hours until the specific treatment can be given to the patient. Even if there is only a remote suspicion of sepsis, the long lead times make clinicians resort to broad spectrum antibiotic therapy, just to be safe until cultures are sufficiently proven to be negative. Resistant strains are a major health-care problem. Infections that would otherwise be trivial may be deadly if the causing agent is resistant to available drugs and treatment of premature babies and immunosuppressed patients (such as patients undergoing organ transplants or chemotherapy) are complicated by this fact. When blood samples are sent to microbiology labs for culturing, cultures that are positive for bacteria or fungi are subjected to antibiotic susceptibility testing. If the infecting agent is resistant to an administered drug, the therapy can be changed to an effective antibiotic. However, the response time for these tests is usually around 72 hours, which is too long to affect treatment for the patient in question. It is not uncommon that the patient has either died or responded to the treatment and is in recovery when the test results are back. With a shortened response time for identification of the infecting agent as well as the antibiotic susceptibility testing, the usage of broad spectrum antibiotics could be reduced significantly.

Health economy effects of 24 h earlier AST results