Sepsis test could show results 'in minutes'

A close-up of the test device

A new rapid test for earlier diagnosis of sepsis is being developed by University of Strathclyde researchers.

The device, which has been tested in a laboratory, may be capable of producing results in two-and-a-half minutes, the Biosensors and Bioelectronics journal study suggests.

Diagnosing sepsis can be a complex process.

The UK Sepsis Trust said it welcomed the research but added that no test was perfect at spotting the condition.

It is estimated that 52,000 people in the UK die every year from sepsis, which is a serious complication of an infection.

There is a lot of research going on to attempt to find out what exactly triggers the sometimes fatal reaction involved in sepsis.

The initial problem can be quite mild and start anywhere - from a cut on the finger to a chest or urine infection - but if left untreated can set off a cascade of reactions, from shock to organ failure and in some cases, death.

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Early diagnosis is key because for every hour that antibiotic treatment is delayed, the likelihood of death increases.

Diagnosis of sepsis is usually based on clinical judgement, body temperature, heart rate, breathing rate, and a series of blood tests.

As soon as sepsis is suspected, broad-acting antibiotics should be given to the patient.

A blood test that aims to determine the best antibiotic to treat the infection can take up to 72 hours.

The new test uses a device to detect if one of the protein biomarkers of sepsis, interleukin-6 (IL-6), is present in the blood.

Dr Damion Corrigan with the microelectrode biosensor device

Dr Damion Corrigan, who helped develop the test, said IL-6 is one of the best markers of sepsis.

"The type of test we envisage could be at the bedside and involve doctors or nurses being able to monitor levels of sepsis biomarkers for themselves."

He said the test would work well in GP surgeries and in A&E to quickly rule sepsis in or out, if it was eventually approved through clinical trials.

Dr Corrigan added that sepsis not only kills people but can also leave them with life-changing problems, such as limb loss, kidney failure and even post-traumatic stress disorder.

The idea is that the device could be implanted and used on patients in intensive care.

Sepsis symptoms

Symptoms in adults:

• Slurred speech or confusion

• Extreme shivering or muscle pain

• Passing no urine in a day

• Severe breathlessness

• It feels like you're going to die

• Skin mottled or discoloured

Symptoms in children:

• Breathing very fast

• Fit or convulsion

• Looks mottled, bluish, or pale

• Has a rash that does not fade when you press it

• Is very lethargic or difficult to wake

• Feels abnormally cold to touch

With early diagnosis and the correct treatment, normally antibiotics, most people make a full recovery.

Source: UK Sepsis Trust

The project's clinical adviser and co-author, Dr David Alcorn, from Paisley's Royal Alexandra Hospital, said the tiny electrode had the potential to detect sepsis and, at the same time, diagnose the type of infection and the recommended antibiotic.

"The implications for this are massive, and the ability to give the right antibiotic at the right time to the right patient is extraordinary.

"I can definitely see this having a clear use in hospitals, not only in this country, but all round the world."

The researchers have applied for funding to develop a prototype device and hope to get commercial interest in taking it forward.

They hope the low-cost test could come into everyday use in three to five years.

Delayed diagnosis of sepsis

Ryan, who contracted sepsis in 2015, lost three stone in weight and struggled to walk after being in a coma

Ryan Sutherland, from Clackmannanshire, ended up in a coma with sepsis, which had been misdiagnosed.

He had felt unwell with a sore throat that got worse, but was told by a doctor it was a viral infection.

"As the week went on, it got worse and by the Thursday it was really bad. My wife took me to the out-of-hours doctor that night and by this point I was really unwell and could barely move. But I was given an anti-sickness injection and then I was sent home."

Hours later he collapsed. He was taken to hospital and suffered two cardiac arrests. His body went into shock with the sepsis and his organs started to shut down.

After eight days in a coma, Ryan woke up and made an almost complete recovery.

"No-one mentioned sepsis, although looking back I had all the symptoms," said Ryan.

"It's hard to diagnose, so if this test had been around it could have made all the difference to what happened with me."

The UK Sepsis Trust estimates that earlier diagnosis and treatment across the UK would save at least 14,000 lives a year.

Dr Ron Daniels, the trust's chief executive officer, said: "Any kind of test that enables us to identify sepsis earlier, before symptoms even present themselves, could help save even more lives and bring us closer to our goal of ending preventable deaths from sepsis.

"Systems like this are so important as, with every hour before the right antibiotics are administered, risk of death increases.

"No test is perfect in the identification of sepsis, so it's crucial we continue to educate clinicians to think sepsis in order to prompt them to use such tests."

Update 19 February 2019: This article has been amended to more accurately reflect the stage of development that this new rapid test has reached and the continuing difficulties in diagnosing sepsis.