Development of multimarker panels for sepsis diagnostics
Sepsis is serious medical condition characterized by a whole-body inflammatory state, termed systemic inflammatory response syndrome (SIRS), and the presence of an infection. Despite of the development in diagnostic and therapeutic techniques, sepsis remains one of the leading causes of morbidity and mortality worldwide. Early recognition and treatment of sepsis is crucial to improve outcomes and reduce sepsis-related mortality.
All over the world, sepsis is associated with high mortality and morbidity. Furthermore, the problems associated with sepsis are expected to increase; the elderly is a major risk group for acquiring sepsis and the proportion of elderly people in the population is expected to increase in the future. An early and accurate detection of sepsis is important, since every hour of delay of appropriate antibiotic therapy increases mortality by 5-10%. Unfortunately, it can be extremely challenging to accurately diagnose sepsis and its related conditions SIRS and multiple organ failure. The manifestations of sepsis are highly variable, depending on patient age group, and are not restricted to simple changes in certain variables. Often the patients do not show classical signs of infections as high fever. Instead, symptoms like vomiting, dyspnea, and abdominal pain, can be present which complicates the diagnosis of these patients. This result in a delay until the patient receives adequate treatment, which in turn can lead to a worsen condition for the patient with more severe complications and longer hospitalization. An early and correct diagnosis of sepsis patients may also lead to a reduction of unnecessary antibiotic use. Since the rate of resistant bacteria have been associated with the frequency of antibiotic consumption, it is extremely important that antibiotics only are used for treating bacterial infections. Blood culture is the current gold standard for diagnosing sepsis, since viable microorganisms isolated from blood cultures can be analyzed to identify species and susceptibility to antimicrobials. However, the practical value of blood culture in the diagnostics of sepsis is hampered by the time-delay of 2-3 days to results and that only 30 to 50% of these patients have positive blood cultures. The usage of biomarkers may aid early diagnosis, and thus, early initiation of appropriate therapy in patients with sepsis. Biomarkers have also been suggested useful for antibiotic stewardship and for personalized therapy.
The aim of this project is to develop multimarker panels to enable earlier recognition of sepsis. Patient samples collected from a previous prospective study of community-acquired sepsis in western Sweden will be screened using high-throughput methods to identify candidate sepsis biomarkers. Computational approaches will be used for optimal selection of clinically useful markers from the large pool of candidates.
The project is performed in close co-production between the University of Skövde (HS), Skaraborg Hospital, TATAA Biocenter AB, MultiD Analyses AB, bioMérieux Sweden AB, and Unilabs AB. The project is planned for three years (2013-2015) and is financially supported by the Knowledge Foundation.
- Diana Tilevik (project manager), University of Skövde
- Anna-Karin Pernestig (project manager), University of Skövde
- Lars Ljungström, Skaraborg Hospital
- Mikael Kubista, TATAA Biocenter AB
- Robert Sjöback, TATAA Biocenter AB
- Eva Arkbladh, Unilabs AB
- Barbara Usener, Unilabs AB
- Teresa Gunnarsson, bioMériuex Sweden AB
- Amin Forootan, MultiD Analyses AB