Counting the Cost of Septicaemia

Septicaemia is a serious, systemic illness that over the past 30 years has become increasingly common among hospitalised patients. Caused by bacteria and bacterial toxins circulating in the bloodstream, it is the 6th most common reason for hospitalisation (USA) and is responsible for more than 266,000 deaths every year1.

Septicaemia can be very difficult to diagnose. Initial symptoms include fever, elevated heart rate and rapid breathing, which are common with many other diseases. Diagnosis is traditionally by blood culture to isolate the infecting bacteria or fungi. However, this can take several days and patients are often treated empirically with broad-spectrum antibiotics until specific information is available from the microbiology laboratory.

Unfortunately, with the increasing incidence of antibiotic resistant pathogens and a lack of new antibiotics to combat them, many patients go without appropriate or effective therapy for days, and in some cases, no antibiotic therapy at all.

Up to 30% of All Positive Blood Cultures are Due to Contamination

Staphylococci are the most frequent causes of bloodstream infections but also of blood culture contamination. Genuine infections with Staphylococcus aureus present considerable clinical challenges with increased mortality rates, prolonged hospital stays and significant extra costs. Blood culture contamination with Coagulase-Negative Staphlococcus (CoNS), on the other hand, leads to unnecessary coverage with broad-spectrum antibiotic therapy and preventable costs.

The challenge for physicians is how to ensure early, appropriate therapy for patients with true infections, while avoiding pointless treatment for those with contaminated blood cultures.

Improved patient outcomes and reduced costs could be achieved by early, specific diagnosis of the underlying infection, to enable more appropriate treatment as soon as possible2.

FISH for a Quick Answer

Identification of bacterial infection by conventional methods employs subculturing, overnight incubation and phenotypic identification. This can take days and delay correct therapy.

Now, new technology provides rapid identification of S. aureus and Coagulase-Negative Staphylococci (CoNS) directly from GPCC-positive blood cultures in just 20 minutes!

Staphylococcus QuickFISH™ from AdvanDx is a fast and easy-to-use test. It enables microbiology laboratories to report S. aureus vs. CoNS results together with the Gram stain critical values call to enable optimised therapy at the critical antibiotic decision point.

QuickFISH is based on revolutionary PNA probe technology and Fluorescence In Situ Hybridisation (FISH). It simplifies testing for the laboratory with fewer steps, less hands-on time (only 5 minutes) and a shorter turn-around time. It includes built-in positive and negative controls and needs no wash steps.

Receiving the pathogen ID at the same time as the Gram Stain result means clinicians can prescribe the correct antimicrobial therapy for septicaemia patients much earlier and avoid unnecessary treatment for patients with CoNS contaminated blood cultures.

Such an advance promotes higher patient survival rates and fewer complications (e.g. drug toxicity, C. difficile infections). Healthcare facilities are better utilised with optimised antibiotic use, reduced hospitals stays and significant cost savings. Staphylococcus QuickFISH™ is now available in the UK from Alpha Laboratories.

This article was published previously in Alpha Laboratories’ Leading Edge Newsletter – Winter 2012.

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References

1. Agency for Healthcare Research and Quality (AHRQ) News and
Numbers, October 6, 2011
2. Surviving Sepsis Campaign www.survivingsepsis.org