Sepsis & Antibiotic Stewardship 

Renal image
Renal image
Renal image

Sepsis may result due to an overwhelming life-threatening response to an infection. The B∙R∙A∙H∙M∙S Procalcitonin (PCT) assay aids in diagnosis of Sepsis and patient management to allow for timely antibiotic therapy, helping prevent serious medical complications.

For in vitro diagnostic use.

Challenges

Around 50 million people develop sepsis each year leading to approximately 11 million deaths worldwide.1

Aggregate hospital costs for sepsis stays in the U.S reached $36.9 billion in both 2020 and 2021.2

Sepsis

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.3 Anyone affected by an infection can progress to sepsis conditions but some vulnerable populations such as elderly people, pregnant women, neonates, hospitalized patients, and people with HIV/AIDS, are at higher risk.4

In sepsis, organ dysfunction can be identified as an acute change in total SOFA (Sequential [Sepsis-related] Organ failure Assessment) score ≥ 2 reflect an overall mortality risk of approximately 10% in a general hospital population with suspected infection.3

Septic shock

It is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients with septic shock can be identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP (Mean Arterial Pressure ≥ 65mm Hg and having a serum lactate level ≥ 2mmol/L (18mg/dL) despite adequate volume resuscitation. With these criteria, hospital mortality is in excess of 40%.3

 

PROCALCITONIN AND SEPSIS5,6

PCT is an inflammatory biomarker that is highly specific to bacterial infection and helps differentiate bacterial infection from other causes of inflammation such as that caused by viral infection. Additionally, it:

  • Helps determine how severe the infection is
  • Helps determine if the patient is responding to treatment (or not)

PCT is a more accurate diagnostic parameter for sepsis, a better predictor of mortality and a more reliable marker than other biomarkers, including C-reactive protein (CRP), Interleukins and Lactate levels.

Recent studies suggest the value of PCT testing among COVID-19 patients as some patients may experience bacterial infections. This testing will help indicate who may benefit from antibiotics as part of their treatment.8

ABBOTT's B·R·A·H·M·S PCT

When making critical decisions, early diagnosis may help you select the best treatment for your patients. 

  • Provide clinicians a risk assessment of critically ill patients on their first day of intensive care unit (ICU) admission for progression of sepsis to septic shock.5,6 
  • Aid in decision making on antibiotic discontinuation for patients with suspected or confirmed sepsis.5,6
  • Excellent clinical sensitivity with a Limit of Quantitation (LoQ) of 0.01ng/mL allowing for early indication, antibiotic stewardship, and negative predictive values.5,6

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References
  1. Sepsis Facts. World Sepsis Day. Sepsis Facts — World Sepsis Day - September 13 https://www.worldsepsisday.org/sepsisfacts (Last  accessed March 12, 2024).
  2. Owens et al., Overview of Outcomes for Inpatients Stays Involving Sepsis, 2016-2021. Agency for healthcare research and quality. https://hcup-us.ahrq.gov/reports/statbriefs/sb306-overview-sepsis-2016-2021.pdf (Last accessed April 2024).
  3. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287. PMID: 26903338; PMCID: PMC4968574.
  4. Sepsis (who.int) https://www.who.int/news-room/fact-sheets/detail/sepsis. doi:https://doi.org/10.3390/cancers13112621 (Last accessed March 12, 2024).
  5. Alinity i B∙R∙A∙H∙M∙S PCT Instructions for Use, G90822R01, November 2017.
  6. ARCHITECT B∙R∙A∙H∙M∙S PCT Instructions for Use, G1-0646/R04, May 2022.
  7. Shiferaw, et al. The Role of Procalcitonin as a Biomarker in Sepsis. J Infect Dis Epidemiology. 2016; 2:006 Vol 2. 
  8. Hessels LM, Speksnijder E, Paternotte N, van Huisstede A, Thijs W, Scheer M, van der Steen-Dieperink M, Knarren L, van Den Bergh JP, Winckers K, Henry R, Simsek S, Boersma WG; COVIDPredict Study Group. Procalcitonin-Guided Antibiotic Prescription in Patients With COVID-19: A Multicenter Observational Cohort Study. Chest. 2023 Sep;164(3):596-605. doi: 10.1016/j.chest.2023.04.032. Epub 2023 Apr 26. PMID: 37116748; PMCID: PMC10132833.