Innovation in sepsis management: rapid POC host response testing

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-in-time’ 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