Sepsis is a life-threatening condition in response to infection. Without rapid treatment, sepsis can result in tissue damage, organ failure or death. Speed is of the essence for sepsis management and faster diagnosis of specific pathogens may help ensure patients receive the most appropriate treatments as soon as possible. Reducing the use of broad-spectrum antibiotics is an essential part of antibiotic stewardship to prevent the emergence of antibiotic resistance. This work explored the potential use of a novel diagnostic test to rapidly detect sepsis-causing pathogens including Gram-negative or Gram-positive bacterial or fungal infections and to aid in the diagnosis of sepsis in severely ill, hospitalised adult patients.
A rapid point-of-care (PoC) test as an adjunct to blood culture to aid the diagnosis of sepsis patients with bloodstream infections may decrease the use of broad-spectrum antibiotics and reduce rates of inappropriate antimicrobial therapy (IAAT) use. Through a decision tree model, taking the perspective of the Irish healthcare provider, the cost-effectiveness of such an intervention was evaluated against the current standard of care (SoC) in hospitalized adults in Ireland.
The base-case scenario showed that using a rapid PoC test was cost-saving and lifesaving, with €8188 saved per death averted. The results were sensitive to the length of hospital stay for patients with true-positive and true-negative results and to the length of stay (LOS) in the intensive care unit. The threshold analysis showed that even at lower sensitivities, the rapid PoC test could be cost-effective due to the substantial impact of starting earlier targeted and appropriate treatment in patients with bloodstream infection (BSI) and sepsis. Clinical studies are ongoing to determine the clinical impact in practice.
Vankelegom M, Burke D, Mohammed AMF, et al. Cost-effectiveness of a rapid point-of-care test for diagnosing patients with suspected bloodstream infection in Ireland. Informatics in Medicine Unlocked [Internet]. 2022 Jan 1;32:101056. Available from: https://www.sciencedirect.com/science/article/pii/S2352914822001952
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