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| Image created by Dr. Michael J. Miller |
A new rapid blood test that could diagnose and monitor patients who are at risk of sepsis is being trialled for the first time at Guy’s and St Thomas’.
Sepsis, also known as ‘blood poisoning’, is hard to identify and there is currently no test to diagnose it. Without prompt treatment, it can lead to multiple organ failure and death. Every year in the UK there are 48,000 sepsis-related deaths, according to the UK Sepsis Trust.
The non-invasive and low-cost test being trialled for the first time in the UK uses patient blood samples to identify high levels of DNA fragments associated with sepsis within just 45 minutes. It could be used to screen patients for sepsis when they present with symptoms in the emergency department (A&E), or if their condition deteriorates on a hospital ward.
Early results suggest the test is able to identify patients who may be at higher risk of developing sepsis and progressing to organ failure. If the trial is successful, the test will help clinicians to identify the sickest patients more quickly and respond faster to prevent a patient getting sicker.
Sepsis occurs when the immune system, the body’s defense mechanism to infection, goes into overdrive. Immune cells, known as neutrophils, release an excessive number of spider-like-webs of DNA in an attempt to trap infections and prevent them spreading further – potentially leading to organ damage. These webs are called neutrophil extracellular traps (NETs).
The test being trialled at Guy’s and St Thomas’ NHS Foundation Trust identifies a protein found in NETs. Quantifying the levels of these in the blood will indicate if someone has too many NETs, and therefore is more likely to have, or develop, sepsis. This is the first time a test to detect NETs directly has been brought to the bedside.
The year long study, launched on 27 November with funding from Volition Diagnostics UK Limited, will test the protein levels of 450 patients with sepsis or septic shock in the intensive care unit at St Thomas’ hospital. No additional blood samples are required from participants in the study. The success of the new test will be compared with the current standard blood tests used by clinicians to evaluate sepsis. These cannot diagnose sepsis in isolation.
If successful, the new test could also help in triaging patients, making it easier to plan admissions and discharge from critical care. Additionally, there is ongoing research into the role of NETs as a potential new treatment for sepsis.
Dr Andrew Retter, critical care consultant at Guy’s and St Thomas’ who is leading the study, said:
Detecting sepsis early is critical to saving lives. Sepsis is the number one cause of death in hospitals and mortality increases as much as 8% for every hour that treatment is delayed.
Being able to spot those patients most at risk of sepsis using a simple blood test would be a paradigm shift in the field and could save thousands of lives every year.
Dr Ron Daniels BEM, Founder and Joint CEO of the UK Sepsis Trust said: "Sepsis is one of the biggest causes of avoidable harm and death within our NHS. Delays in diagnosis results not only in lives lost, and not only in increased cost of care, but also in poor outcomes for survivors, including disability.
"Any test which can help us to identify which patients are at increased risk of sepsis can ensure that we identify and treat patients with the most urgent need first: if this research demonstrates that NET proteins fulfil their promise as a risk stratification tool then lives will undoubtedly be saved."