Sepsis, commonly known as blood poisoning, is a bacterial infection of the blood. It is dangerous for adults. And it is often mortal for young children, if left untreated. Amongst neonates and premature children the occurrence of sepsis can be as high as 40% to 50%. The most virulent variety can kill within hours. No wonder sepsis is considered one of the most challenging problems when providing medical care to newborn infants. This explains why a fast and effective diagnostic method for sepsis is eagerly awaited, specifically in maternity hospitals. This is exactly what ASCMicroPlat, an EU funded research project, promises. It could then lead to use of effective antibiotics, tailored to the specific type of sepsis identified.
Fast solutions are required. But how fast is fast? In what sense is the new diagnostic technology different from the present day methods? “ASCMicroPlat is, in fact, a lab on a disc, that can identify sepsis up to 20 times faster than present day methods,” says Gregor Czilwik, engineer of microsystems technology, and project manager at HSG-IMIT, in Freiburg, Germany. “We ultimately aim for a fully automated system whereby a drop of blood goes in, a lab technician pushes a button, and two hours later […] the specific type of sepsis is identified,” Czilwik tells youris.com. Gregor Czilwik estimates that the test would cost around 50 euros a piece, which is similar to the cost of existing tests.
The speed at which this solution operates constitutes a real progress. “These days, the normal diagnostic methods for sepsis take at least a day, usually 48 hours, and can run up to 5 days, “ notes Arie Bos, head of the department of neonatology in the Princess Beatrix Children’s Hospital in Groningen, The Netherlands. “A blood sample needs to be separated in different components,” Bos continues, “then it must be cultivated, often for days, and then analysed. It’s very time consuming.”
Currently, infants suspected of having contracted sepsis, while waiting for the results of the test, are given a preventive dose of broad spectrum antibiotics. “The condition of the patient can worsen visibly within minutes and kill within hours so we couldn’t possibly wait for days,” Bos says. As a result, antibiotics are often administered unnecessarily; an unwanted side effect in view of the ever bigger problem of resistance against antibiotics.
Other experts concurs that this is a much awaited progress. “It would be welcome to be able to give the infant the right type of antibiotics within a few hours,” comments Axel Heep, a German professor of neonatal medicine and paediatrics, working as coordinator of the department of neonatology at the University of Bristol, in the UK. “It will make the treatment much more effective, or to stop medication in case of a false alarm,” he tells youris.com.
But will the new device indeed be the next gold standard? This remains to be seen. The inventors have proven it can detect the bacteria causing sepsis. And the design is nearly finished. The last phase of the project will be to test it during the summer of 2014 with some 30 sepsis-positive, and 300 sepsis-negative samples that have been collected by partner scientists at Trinity College Dublin. The next step after that would be for the test to be validated through clinical studies in patients.
Source: youris.com
The lab on a chip idea could be an advance in early detection of sepsis. However using 1 drop of blood, unless it is a PCR or RT-PCR or other NAAT targeting free bacterial DNA or maybe patterns of mRNA from inflammatory cells, would seem to be plagued with the challenges other rapid methods have faced. The organism load is not that high, especially in early sepsis where we are more likely to impact morbidity and mortality. There simply may not be even a single organism in a single drop of blood - which is why we want in the range of 10 ml of blood for culture. It will be interesting to learn more about how the assay is designed to work and to follow its development.
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