Sepsis - a growing threat to public health

Sepsis or, more commonly, blood poisoning causes more deaths than prostate cancer, breast cancer, and AIDS combined. 30 million people get sepsis every year, and 20 people die from it every minute. Sepsis is the body’s extreme response to an infection. It happens when an infection you already have, for example in your lungs, triggers a chain reaction throughout your body.

Sepsis is life-threatening, and without timely treatment, it can cause organ failure and death.  Antimicrobial therapy is a key element in treatment – in septic shock, the initiation of antibiotic therapy within one hour increases survival; with each hour antibiotic therapy is delayed, survival decreases by about 8% (Kumar et al. Crit Care Med. 2006)

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 (AST). 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