Blood test for sepsis could save lives of thousands of children

A blood test could save the lives of children with sepsis by detecting the deadliness of the condition.

Sepsis affects around 260,000 people a year in the UK, and kills at least 52,000, causing more avoidable deaths than breast, bowel and prostate cancer combined.

Now scientists have developed a test for the ‘silent killer’ which shows how likely it is to cause death.

The blood test, which searches for five proteins released by the immune system, can group children into those at low, medium or high risk of having killer sepsis.

Those in most danger can be rushed to intensive care, treated faster and given more antibiotics to kill the greater number of bacteria causing the immune reaction.

Sepsis affects around 260,000 people a year in the UK, and kills at least 52,000, causing more avoidable deaths than breast, bowel and prostate cancer combined. Now scientists have developed a test for the ‘silent killer’ which shows how likely it is to cause death

Children at lowest risk can avoid receiving too many toxic antibiotics which may cause side effects such as liver damage.

Perhaps more importantly the test provides an insight into a future drug treatment for sepsis. The proteins it detects may fuel the overreaction of the immune system which can lead to septic shock and death from organ failure.

An experiment in mice suggests drugs could be used to lower levels of these proteins, which might help to keep children’s immune systems in check.

Researchers, who tried out their test on 461 children with sepsis, said 97 per cent of those in the low-risk group survived, compared to only 56 per cent of those in the high-risk group.

Dr Hector Wong, from Cincinnati Children’s Hospital, who led a study on the test published in the journal Science Translational Medicine, said: ‘Understanding the risk for a child with sepsis is fundamental for making decisions about their treatment.

‘At the moment this depends on the doctor examining them, with more experienced doctors more likely to make the right call.

‘A blood test like ours, which we hope could be available within two years, could give doctors the same objective information to judge these cases whether they are in a tiny rural medical centre or a large city hospital.

‘It could give children a better chance when it comes to surviving this potentially deadly condition.’

The Mail launched its End the Sepsis Scandal campaign three years ago after William Mead tragically died at 12 months old following a string of errors by NHS helpline staff and doctors.

Sepsis, which is particularly deadly for very young children and the elderly, happens when an infection like blood poisoning triggers a violent immune response, which can lead the body to attack its own organs.

The new test detects five proteins caused by this immune response, engineering fluorescent antibodies in the lab which attach to the proteins so they can see them in a sample of blood.

Simply, the more proteins there are, the greater the risk of the patient dying from sepsis. This could also help to identify the more serious patients who could be helped in trials for experimental drugs.

Researchers used a version of the test on 461 patients aged from one to 18 years old.

Unpublished results show 44 per cent of those flagged as high-risk patients died from sepsis, compared to 18 per cent of those in the medium-risk group and three per cent of those judged to be low-risk, Dr Wong told the Mail.

When the test was applied to mice with medical problems similar to sepsis, it was very accurate, and high-risk mice given double the dose of antibiotics were more likely to survive.

The findings may lead to a better treatment for sepsis in the future, as high-risk animals given an antibody to fight one of the proteins caused by sepsis were slightly, although not significantly, less likely to die. 

WHAT IS SEPSIS?

Sepsis occurs when the body reacts to an infection by attacking its own organs and tissues.

Some 44,000 people die from sepsis every year in the UK. Worldwide, someone dies from the condition every 3.5 seconds. 

Sepsis has similar symptoms to flu, gastroenteritis and a chest infection.

These include:

  • Slurred speech or confusion
  • Extreme shivering or muscle pain
  • Passing no urine in a day
  • Severe breathlessness
  • It feels like you are dying
  • Skin mottled or discoloured

Symptoms in children are:

  • Fast breathing
  • Fits or convulsions
  • Mottled, bluish or pale skin
  • Rashes that do not fade when pressed
  • Lethargy
  • Feeling abnormally cold

Under fives may be vomiting repeatedly, not feeding or not urinating for 12 hours. 

Anyone can develop sepsis but it is most common in people who have recently had surgery, have a urinary catheter or have stayed in hospital for a long time.

Other at-risk people include those with weak immune systems, chemotherapy patients, pregnant women, the elderly and the very young.

Treatment varies depending on the site of the infection but involves antibiotics, IV fluids and oxygen, if necessary.

Source: UK Sepsis Trust and NHS Choices

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