Clinical Microbiology's Response to Sepsis
One session at the American Society for Microbiology this morning was titled "Code Sepsis: Clinical Microbiology Responds to Sepsis." Donna Wolk from the University of Arizona reiterated some of the staggering numbers associated with sepsis: It's the tenth leading cause of death in the United States, translating into 600 patients dying each day. Sepsis results in approximately $16 billion in hospital inpatient costs, says Wolk.
The microbiology lab plays a critical role in identifying and managing sepsis, and needs to remain cognizant of the many important factors involved in effective identification of pathogens that can cause sepsis. For example, the timing of blood draws for culturing is critical, Carol Spiegel, University of Wisconsin says. Draws should be performed prior to the start of antibiotic therapy and at the onset of a new fever in a patient. It's also important to perform two draws, so that if one culture is positive, the lab can differentiate between endocarditis, bacteremia and a contaminant.
Finally, says Spiegel, the amount of blood drawn is the "single most important factor influencing sensitivity of blood cultures." For adults, 30-40 mL of blood should be cultured; volumes for children should be determined by weight.
Wolk stresses the importance of implementing rapid methods of detection to allow physicians to start targeted therapy sooner and minimize the use of broad-spectrum antibiotics. For hospital microbiology labs, she suggests collaboration with the ICU and emergency department teams to best manage sepsis.