FEATURE BIOPHOTONICS Is a
solution for sepsis in sight?
Illustration of a microbe
travelling through a blood vessel. Sepsis occurs when an infection spreads through the blood
Jessica Rowbury looks at how photonics is helping to tackle the challenges associated with diagnosing sepsis
S
epsis, or blood poisoning, is a global healthcare problem. More common than heart attacks, and
claiming more lives than any cancer, the condition is one the biggest killers in the developed world1
. Such a high
mortality rate is largely due to the fact that current diagnostic methods cannot diagnose patients in time to treat them. However, photonics is enabling the development of systems that can diagnose sepsis in hours, as opposed to days typically required by existing techniques. These faster systems promise to not only save countless lives, but help to prevent antibiotic resistance and reduce the global health-economic burden. Sepsis occurs when an infection
spreads through the bloodstream to other areas of the body, causing tissue damage and organ failure. It is often described as a silent killer, as its
symptoms often suggest less serious illnesses such as influenza, making it extremely difficult to identify for both healthcare professionals and the public.
But even if doctors manage to
recognise the condition, treating sepsis carries its own challenges. Doctors must identify the bacteria that caused the infection in order to deliver the most effective treatment. However, this is a time-consuming and complex process, explained Professor Jürgen Popp, director of the Institute of Photonic Technology (IPHT) in Jena, Germany: ‘Most of the currently existing microbiological approaches to characterise microorganisms rely on cultivation (i.e. the pathogens will be cultivated from patient blood samples) which often takes several days.’
Seeing as most cases of sepsis end fatally within around 48 hours, it is clear that current diagnostic methods
32 ELECTRO OPTICS l FEBRUARY 2016
are not fast enough. ‘Currently, there is no really good test system that can unequivocally diagnose sepsis at an early stage,’ said Professor Popp. Sepsis is one of the biggest killers in the United States, claiming more lives than prostate cancer, breast cancer, and AIDS combined. In England, sepsis is the second leading cause of death after cardiovascular disease, and in Germany, it is the third.
Healthcare authorities are indeed struggling to deal with the challenge of sepsis. In December 2015, the UK’s National Health Service (NHS) released a ‘sepsis action plan’ on how to reduce the number of deaths from the condition2
. The plan said doctors
are limited by their ‘lack of laboratory services’ in their ’ability to distinguish between sepsis, severe sepsis and septic shock’.
But not being able to diagnose
and treat sepsis effectively is also contributing to an even larger healthcare crisis; antibiotic resistance. Due to the seriousness of the condition, if a doctor suspects sepsis then they will start the patient on broad-spectrum antibiotics,
as previously mentioned – there simply isn’t enough time to wait for lab results. This overuse of broad- spectrum antibiotics contributes to the creation of ‘superbugs’, strains of bacteria that are resistant to several types of antibiotic treatments. ‘Treatment with broad spectrum antibiotics increases the likelihood of the infectious agent mutating in order to resist the antibiotic,’ explained Dr Kavita Aswani, senior applications scientist, life sciences, Excelitas. ‘This is how the whole MRSA issue in hospitals came about. Bacteria and other infectious agents are becoming smarter and developing resistance to antibiotics, making it trickier to treat these infections. ‘There is a need to be able to identify sepsis infections quickly… so the physician doesn’t have to start the patient on a broad range of antibiotics. They can treat the patient according to the infection they have,’ Aswani said.
The speed of light It’s not all bad news, however. There are many research institutions and biomedical companies working to
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