Innovation in point of care sepsis diagnostics

Sepsis is a life-threatening reaction to an infection, resulting in the immune system overreacting and the beginning of damage to the body’s own tissues and organs. Against a background of ongoing diagnostic research, Charlotte Duncan provides an overview and introduces the latest in point-of-care technology.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.¹ According to The UK Sepsis Trust, 250,000 people per year are affected by sepsis, of which 52,000 people die and 60,000 people suffer permanent, life-changing after effects.² The often quoted aphorism that sepsis kills more people in the UK than bowel, breast and prostate cancer combined³ rather poignantly gives a sense of the scale of the problem. Indeed, the global picture is even more grim with sepsis causing an estimated ¹¹ million deaths each year, and data showing those in vulnerable groups and low-resource settings account for 85% of these cases.⁴ In May 2017, the World Health Organization (WHO) issued a resolution confirming sepsis is a worldwide issue.⁵

Given the significant disease burden in the UK, and globally, the diagnostic support to clinicians is lacking.⁶ Routine tests such as C-reactive protein (CRP), blood count, lactate⁷ and procalcitonin8 offer limited information on the inflammatory response of the patient in the form of ‘point-intime’ assessments, requiring serial testing to obtain an indication of response to treatment, while most innovation focuses on bloodstream infections and subsequent identification and antimicrobial susceptibility testing (AST). Identification of a pathogen can allow clinicians to optimise antimicrobial therapy. Depending on the identification and AST result of an infecting organism, escalation or de-escalation of antibiotics and adjusting modes of administration can result in improved patient care⁹ and outcome, and support antimicrobial stewardship.¹⁰