25 August 2021
Every year, about 48 million people are diagnosed with sepsis worldwide. 1 out of 5 people with sepsis die – and this represents 18 to 20% of annual global deaths. Almost half of these are children, with neonatal and pediatric sepsis accounting for 20 million cases. These are devastating numbers.
The Asia-Pacific region has the highest incidence of sepsis in the world – estimates have revealed that up to 1600 per 100,000 people are afflicted with the disease. The death rate in these countries reach as high as 35%.
Sepsis is a fatal multi-organ failure resulting from dysregulated immune response to infection. Any infection can progress to sepsis, but there are populations at higher risk such as the elderly, pregnant women, newborns, individuals without a spleen, and those with pre-existing diseases that weaken the immune system. Signs and symptoms are non-specific and may include fever, altered mental status, increased heart rate, weak pulses, decreased urine output, and fatigue.
The disease does not stop at eradicating the pathogenic organisms. Many survivors of sepsis continue to suffer from lifelong complications like fatigue, anxiety, muscle weakness, and mental health problems. In the hospital, it is common to see a patient walk in with a seemingly harmless infection, only to discover that sepsis is already present. Often, admission to the intensive care unit is necessary.
Early recognition and detection of sepsis is crucial and it is essential to initiate prompt antimicrobial treatment. Screening tests that are currently being investigated for use are biomarkers like C reactive protein and procalcitonin. Still, the standard of diagnosis is blood culture and pathogen identification. This process takes an average of 2 to 3 days – and only 30 to 40% of cultures show microbial growth. By then, empiric antibiotic treatment has been started, and the risk of antimicrobial resistance remains present.
Timely and accurate identification of pathogens that cause sepsis still poses a great challenge to healthcare providers. There is light at the end of the tunnel, however, with the discovery of newer and speedier diagnostic modalities. At Micronbrane Medical, metagenomic next generation sequencing (mNGS) coupled with a patented blood fractionation device that reduces host cell interference, the time to diagnosis is greatly reduced. Accurate pathogen identification can be delivered in less than 24 hours.
For patients and clinicians, this means earlier initiation of definitive antimicrobial treatment. Studies have shown that sepsis-related mortality decreases up to 30% when an appropriate antibiotic therapy is administered within the first 24 to 48 hours. Length of hospital stay, the cost of treatment, and problems with antimicrobial resistance is dramatically lessened.
Devin® is a device that selectively depletes 95% of leukocytes in the blood through a specialized filtration technique called antifouling Zwitterionic coating technology. Depletion of leukocytes increases sensitivity in detecting pathogens by removing host interference from the blood. After nucleic acid extraction, PartiSeq® uses the next generation sequencing technology that delivers results in less than 24 hours. Compared to the traditional blood culture which may take up to 7 days, and even recent metagenomic next generation sequencing that takes 1 to 2 days to release results, Micronbrane delivers a promising method that significantly reduces waiting time.
References