Sepsis in children

Rapid diagnosis of sepsis in children using gene-expression signatures

Sepsis is a rare and life-threatening condition caused by an abnormal reaction to infection in the body leading to organ dysfunction. It can be particularly high-risk for some groups, including children and infants. Improved diagnostics have the potential to reduce length of hospital stays by improving timely patient treatment in children with sepsis and reducing unnecessary treatment in children where sepsis is ruled out.

This project is developing and testing novel sepsis markers to improve the accuracy of sepsis diagnosis in children. The vision is that this will result in improved patient outcomes and better management of antimicrobials. It focuses on the feasibility of gene-expression-based sepsis diagnosis to more accurately diagnose sepsis in children.

Outcomes

• The initial proposal was to test a few candidate markers to diagnose sepsis; however, a decrease in costs has resulted in the ability to do a full transcriptome (i.e. analysing how the full set of genes are activated during sepsis).
• The study extended beyond the scope of the original application (which was made possible due to additional MRFF grant), with over 1200 study participants currently recruited (twice the original number proposed) from Queensland Children’s Hospital, Gold Coast University Hospital, Townsville Hospital and Thursday Island. Ultimately, the aim is to enrol a total of 1400 children in the study. Most children were recruited in emergency departments, while over 250 were recruited in paediatric intensive care units (PICU). 
• The study aims to demonstrate proof of the concept that a gene expression test can be conducted in the future and that this may yield faster results compared to the time-consuming method of culture testing within a laboratory. As our knowledge on transcriptomics increases, novel and more complex signatures emerge. The project aims to combine markers of infection with markers of severity to identify which children necessitate antibiotics, and which are at high risk of deterioration potentially needing life support.

Project investigators

Project investigators engage with and draw on the expertise of partners within universities, research institutes, and hospital and health services around Queensland.

• Associate Professor Luregn Schlapbach, Associate Professor Kristen Gibbons, Queensland Children’s Hospital, The University of Queensland (Co-Leads)