Sepsis
Tackling sepsis and antimicrobial stewardship
bioMérieux recently hosted an educational symposium on ‘the critical intersection between antimicrobial stewardship and sepsis’. Often perceived as separate, these two issues are intrinsically linked. The event, which took place in Birmingham, provided a thought-provoking exploration of these two critical healthcare challenges. CSJ provides an overview of some of the hot topics discussed.
Each year, World Sepsis Day takes place on 13 September, an initiative by the Global Sepsis Alliance. Sepsis is a major healthcare challenge, with 47 to 50 million sepsis cases per year; 1 in 5 deaths worldwide are associated with sepsis, while 40% of cases are children under five years old.1
At the same time, another major healthcare
challenge is looming – the World Health Organization (WHO) declared antimicrobial resistance (AMR) as one of the top 10 global public health threats, and AMR is listed on the UK Government’s National Risk Register. Predictions suggest that more than 39 million people around the world could die from antibiotic-resistant infections over the next 25 years.2 To tackle these interlinked challenges, we
need to address the critical intersection of sepsis and antimicrobial stewardship. Getting the basics right will be vital and experts gathered at the symposium to discuss a range of issues – from the difficulties of spotting sepsis in busy emergency departments, to
achieving antibiotic stewardship in difficult groups. The speakers highlighted the need to address the challenges encountered when integrating new technologies into our current healthcare system – while innovations in diagnostics and treatments offer hope, their impact is often undermined by fractured infrastructure, limited accessibility, and inconsistent policies. Using blood cultures as an example, best
practices for collection are crucial before meaningful improvements can take place later in the pathway. It is clear that without getting the basics right first, and addressing foundational system failures, technology alone cannot effectively tackle global health issues like Sepsis and AMR.
Although AMR and sepsis may seem like distant threats to the public at the moment, reframing the conversation to emphasise personal stakes, such as the ability to receive effective treatments for given infections, could
mobilise broader engagement. The inclusion of patient testimonials, during the symposium, provided a stark reminder of exactly what is at stake and reinforced the importance of listening to patients’ experiences. This article provides an overview of some of
the hot topics discussed at the event – from insights into some of the challenges faced by clinicians, at the frontline of healthcare delivery, to strategies to drive improvement.
Spotting the ‘sepsis needle’ in the emergency department Overprescribing of antibiotics in paediatrics accounts for a significant proportion of inappropriate antibiotic use in human healthcare, thereby contributing to the global health emergency of antimicrobial resistance. As Professor Damian Roland pointed out in his opening discussion, decision making in the emergency room can be particularly challenging, especially when dealing with infants.
An Honorary Professor in Paediatric
Emergency Medicine, at Leicester Hospitals and University, Prof. Damian Roland has an international profile in the utilisation of scoring systems to improve the recognition of ill and injured children in emergency and acute care settings. The Paediatric Observation Priority Score (POPS) developed by Prof. Roland is highlighted by the Intercollegiate Committee on Standards of Care for Children and Young People in emergency settings.3 POPS is a bespoke Emergency and Urgent
Sepsis survivor, Lord Mackinlay of Richborough, provided a political and patient perspective.
care checklist which quickly scores (between 0-16) acutely ill children on a combination of physiological, behavioural and risk identifiers using easy to collect data. This enables staff (even if inexperienced) to assess, prioritise and treat acutely ill children, and manage risk in busy clinical areas. Prof. Roland opened the discussion by
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