22 November 2023
Researchers from The University of Queensland (UQ) teamed up with several Brisbane hospitals to investigate a new approach to speed up the diagnosis and treatment of critically ill children and adults with sepsis.
Led by UQ, DIRECT was a collaborative project that included the Princess Alexandra Hospital, Royal Brisbane and Women’s Hospital, The Prince Charles Hospital and Queensland Children’s Hospital.
The multi-hospital project DIRECT set out to investigate the feasibility of integrating innovative diagnostics and treatment for sepsis. Sepsis is a life-threatening condition that occurs when the body's response to an infection damages its own tissues. Early diagnosis and prompt treatment is essential as each hour delay in administering antibiotics increases risk of death in critically ill patients by close to 8%*.
Lead investigator Professor Jason Roberts from UQ said DIRECT aimed to use whole genome sequencing to speed up the diagnosis of sepsis, and antibiotic dosing software to determine correct dosages and optimise treatment times for patients.
“We studied 156 children and adults with suspected sepsis who were being treated with antibiotics,” he said.
“During their treatment, we monitored how long it took for patients to achieve predetermined antibiotic targets, or in other words how long it took for the antibiotics to be effective.
“We found that some failed to reach predetermined antibiotic targets in the first 24 hours of treatment.
“However, we found that using dosing software reduced the time to achieve antibiotic targets by more than 48 hours in some patients. Clinicians could achieve this by entering their patient’s data into the dosing software to receive an individualised dosing recommendation, and then adjust dosages dependent on the antibiotic levels achieved. It was an exciting result.”
DIRECT also looked at whether whole genome sequencing could be used to speed up the diagnosis of sepsis in a clinical setting. Currently, clinicians use blood culture testing to diagnose sepsis, which can take up to 5 days. The study found that sepsis diagnosis using metagenomic sequencing from blood cultures was accurate and feasible.
Co-lead Dr Adam Irwin from UQ and QCH said the project’s outcomes were a direct result of the excellent collaboration between the university and the 4 intensive care units (ICUs) at participating hospitals.
“The expertise and knowledge shared by our partners at hospital and health services around Queensland was invaluable,” he said.
Researcher Dr Sainath Raman from Queensland Children’s Hospital said the multi-hospital study allowed the team to look at what clinical pathways worked better than others.
“One of the benefits of being involved in this study was learning how one hospital might do something better than another hospital, and then how to translate that to all sites,” he said.
The DIRECT project was supported by funding from the Australian Government under the Medical Research Future Fund (MRFF), with funding distributed by Health Translation Queensland.
* Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006;34:1589-96.
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