TESTING TIMES
Life-saving new sepsis test has ‘100% match rate’ with results in record time
Plus, symptoms of sepsis to spot in your child and everything you need to know about 'Martha's rule'
SCIENTISTS have developed a new life-saving sepsis test that produces results in record time with an "100 per cent match rate".
It can take days for current tests to identify the pathogens causing a life-threatening sepsis reaction.
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A test developed by Korean researchers could identify the species causing the infection in a matter of hours, with the potential to give patients targeted treatments faster.
Sepsis is a life-threatening reaction to an infection.
It occurs when the body's immune system - which normally helps to protect us and fight off infections - overreacts to an infection and injures tissues and organs.
It can lead to shock, multiple organ failure and sometimes death, especially if not recognised early and treated promptly, according to The UK Sepsis Trust.
Read more on sepsis
Some people can develop sepsis is response to common ailments like chest or urinary tract infections (UTIs) - it's not known exactly why.
It primarily affects very young children and older adults, but can be triggered in anyone.
There is no single sign or diagnostic test to spot sepsis, which is usually treated with antibiotics.
According to researchers Seoul National University, treatment can be tailored to patients using what's known as antimicrobial susceptibility testing.
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This uses cultures from bacteria or fungi specimens taken from patients to determine which antibiotics would be most effective and if bacteria have growth resistant to them.
However, this process of taking a blood culture sample and testing it typically takes two to three days.
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This requires doctors to use a broad-spectrum of antibiotics - classes of drugs that target an extensive range of disease causing bacteria - on patients in the meantime.
"This implies that often inadequate prescriptions made
during the initial treatment phase might jeopardise patient survival
until a valid AST result is available," researchers - lead by Prof Sunghoon Kwon - said in the study published to the journal Nature.
"Although the disease can often be treatable, patient outcome relies heavily on timing of treatment.
"Delays in appropriate antibiotic delivery have been shown to significantly impact patient survival rates, particularly among those with septic shock."
What are the symptoms of sepsis?
SEPSIS is a life-threatening reaction to an infection that happens when your immune system overreacts and starts to damage your body's own tissues and organs.
Symptoms of sepsis in an adult include:
- Acting confused, slurred speech or not making sense
- Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
- A rash that does not fade when you roll a glass over it, the same as meningitis
- Difficulty breathing, breathlessness or breathing very fast
Symptoms in a child include:
- Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
- A rash that does not fade when you roll a glass over it, the same as meningitis
- Difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
- A weak, high-pitched cry that's not like their normal cry
- Not responding like they normally do, or not interested in feeding or normal activities
- Being sleepier than normal or having difficulty waking
They may not have all these symptoms.
If you think you or someone else has symptoms of sepsis, call 999 or go to A&E.
Source: NHS
They added in a press release: "Finding ways to reduce the turnaround time associated with antimicrobial susceptibility testing is crucial to decreasing the risk of death from sepsis and reducing the unnecessary use of antibiotics."
The team developed an an ultra-rapid antimicrobial susceptibility testing method, that bypasses the need for blood culturing.
Instead, researchers were able to perform drug susceptibility profiling directly from the patient’s whole blood - meaning none of its components have to be separated or removed.
Their method used a synthetic peptide to recover a broad range of pathogens from the blood, which then can be identified and tested for drug susceptibility.
Study authors claimed this new approach has the potential to reduce the turnaround time of the test by more than 40–60 hours, compared to existing methods.
The authors tested their method in a hospital setting, on 190 hospitalised patients with suspected infections.
They sampled 5–10 ml of whole blood was sampled from each patient, from catheter lines and parts of the body where an abnormal increase in temperature was noticed.
All samples were analysed according to hospital protocols, as well as with the new test.
The researchers' method achieved a 100 per cent match rate in species identification, they stated.
For the six positive cases, the average test turnaround time was approximately 13 hours from initial blood processing.
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Further clinical validation of the test is needed to verify the findings on a diverse cohort of people, authors noted.
"However, these results suggest this method has the potential to reduce both the time taken to tackle sepsis and the amount of unnecessary antibiotics used during broad-spectrum treatment," they said.
Martha's Rule
Named after teenage Martha Mills - who died of sepsis despite her parents' pleas that she wasn't receiving the necessary care - 'Martha's rule' gives patients a right to second medical opinion.
Martha, 13, died from sepsis in 2021 after medics failed to boost her to intensive care when her parents raised concerns about her rapidly deteriorating condition.
The rule will give patients and their families access to a rapid review if they are worried about their condition.
NHS England pledged to introduce 'Martha's Rule' to at least 100 hospitals in February.
But it announced today that 143 sites will roll out the rule change by March 2025 following "significant interest" from hospitals across the country.
The purpose of Martha’s Rule is to provide "a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to", NHSE said.
Described as a "three-step safety net", the rule will be made up of three components.
Firstly, an escalation process will be available 24/7 at all the 143 sites.
This will be advertised throughout the hospitals on posters and leaflets, so patients and families can contact a critical care outreach team that can swiftly assess a case and escalate care if necessary.
Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition.
Finally, clinicians at participating hospitals will also be obligated to formally record insights and information about a patient’s health provided by their families daily.
This will ensure that any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff, NHSE said.
Read more on 'Martha's rule' here.