Systemic inflammatory response syndrome (SIRS) is an inflammatory state of the whole body without a proven source of infection. Such is the seriousness of this condition that patients exhibiting SIRS symptoms, such as raised or lowered body temperature, increased heart rate, abnormal respiration and abnormal leukocyte counts, are usually treated within Intensive Care Units. When symptoms are confirmed as being the result of an infection, the patient is described as suffering from sepsis, also known as blood poisoning.

Sepsis appears when pathogens (microbes such as bacteria or fungi) are spread, via the blood stream, from a local source of infection to the whole body. The body over-reacts to the infection with an excessive immune response, essentially deregulating normal defense and repair mechanisms. If the reaction is too strong, the patient dies from multi-organ dysfunction.

Sepsis is not only a problem associated with intensive care or occurring in patients with lowered immune responses. It can result from a small surface wound or an infected tooth. However, it is estimated that every second patient suffering from sepsis dies. The lack of fast, specific diagnostic tests is one reason for that high rate.

The first hours after the onset of sepsis are crucial, yet physicians are faced with critical challenges when presented with a patient that may be suffering from sepsis. Firstly, the symptoms are rather broad and easily confused with those of other infections such as pneumonia. Secondly, conventional diagnostic techniques, typically blood culture analysis to identify the causative infective agents and so determine the appropriate treatment, are slow to deliver results.

Consequently, a diagnosis of sepsis may be made too late and with insufficient information to determine the most effective treatment. The result is a mortality rate of 50%.(2) It has been calculated that every hour of delay in giving the correct treatment increases the chance of mortality by 5- 7% (3). Yet results from blood culture analysis can be expected no earlier than two days after sampling - too late to have influenced the physician's treatment decision in the crucial hours after sepsis' onset.

Modern DNA-based diagnostic techniques, developed at SIRS-Lab, now enable physicians, within hours, to identify sepsis and, in addition, to detect the pathogens. With source control (most often early anti-infective therapy) still the cornerstone of treatment in severe infections, physicians can now confidently decide upon an effective therapeutic regime - at the earliest possible opportunity.

Recent data proves that lethality almost doubles with inadequate anti-infective treatment (4) confirming the need to tailor a therapy to the specific pathogen and its resistance pattern. By providing precise information about the nature of the pathogen, DNA-based diagnostic tests help physicians to target specific pathogens with appropriate therapies.

 

Yet, the application of these new diagnostics techniques does not stop with detection and identification. The physician can continue to monitor the patient's immune response, giving the opportunity to adjust a treatment regime if required.