**EP263: An Exciting New Approach to Sepsis**
**Dr. Warwick Bishop:** I believe we can prevent heart attacks. We can put in place strategies to reduce risk. We can literally plan to change your future. Welcome. My name is Dr. Warwick Bishop, and I'm a cardiologist, an author, a keynote speaker, and CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible, and that includes heart attacks, which impact Australia enormously. We're talking about a heart attack almost every 10 minutes and over 20 people per day dying from a heart attack in Australia. That's on a backdrop of over 9 million people globally being impacted. The sad truth is many of these could have been averted if only we knew what to do. Well, this podcast is all about that: weight, blood pressure, cholesterol, general health, and driving health literacy. I'm on a mission to help not just prevent heart attacks, but improve general health on a global scale. If you enjoy this podcast, I would be honoured if you could give it a five-star review and share it with your family and friends. It may even lead to saving someone you love.
Hi, my name's Dr. Warwick Bishop, and welcome to my podcast and videocast station. Look, I really do appreciate you tuning in, and I hope you find today's podcast interesting and informative. I certainly have found it interesting, and that's why I'm keen to share it. This particular topic is in regard to infections in the blood, or a term that we use is sepsis.
So, infections in the blood, sepsis. Now, I've got some US figures. It can affect about 1.7 million people per annum in the United States, and of those, 350,000 die. So this is a big deal. Infections within the blood, sepsis, are a huge problem and a very high-risk medical situation.
When we've suspected someone has sepsis, when we thought someone has an infection in the blood, what we've done is come to that conclusion because they may have a temperature. They may be sweaty, coughing, looking like they've got an infection. They may have rigors, shakes, shivers. And there'd be clues to point towards a possible infection within the blood.
Now, the way we've proven that for many years is to do what we call blood cultures. Blood cultures are a culture of blood taken from that patient. The way we do it is using an aseptic technique, obviously, so that we don't contaminate our samples. Our blood culture bottles generally include an aerobic, so oxygen-friendly, and an anaerobic bottle, so that's without oxygen in it. That's because we can see infections in the blood from organisms that may be aerobic, i.e., need oxygen, and infections that may be anaerobic that don't need oxygen.
So we collect blood from generally a clean site from the patient. We inject that blood immediately into our blood culture bottles, and then we have to wait about 24 to 48 hours for something to grow in those bottles to tell us if there's actually bacteria within the circulation of that patient who we're evaluating. It takes about 24 hours to give us a clue as to whether there's something growing in the blood culture bottles, but importantly, we keep on growing and then we test different antibiotics against those cultures so that we get a good idea of what therapy this particular infection may be responsive to. So we're talking about a process that could take several days.
Well, the reason to tell you that is to tell you this. I came across a very interesting article the other day which was a new technology for trying to identify sepsis. Now, this is what they did. They took whole blood from a patient. So instead of just like a blood culture, they stick a needle in, obviously using sterile technique, pull out a heap of blood, and then dry that blood out. Through the technique that they use, they turn that blood into, if you like, a clump of dry tissue.
Now, that solid porous structure that results from the process of drying through heating of that blood—obviously, if there are bacteria in the blood through the sepsis, some of that bacteria will be present in the sample taken, and that bacteria will have DNA. So what happens is that they take this porous blood sample and run it through a DNA amplification and matching analysis process. And believe it or not, using this technology, they're able to turn up specific bacteria.
Now, of course, they have to know what they're looking for, but they've demonstrated proof of concept with methicillin-resistant Staphylococcus aureus, or MRSA, which is a nasty, nasty bug. They've demonstrated efficacy with methicillin-susceptible Staphylococcus aureus, which is important to know. They've demonstrated with Escherichia coli, and they've also been able to identify some fungal species, specifically Candida albicans.
Now, this technique takes about one mil of blood and can be performed in two and a half hours. So what an amazing potential advance! The limitation, of course, at this stage is that there isn't that benefit to grow out those cultures of bacteria and test them against different antibiotics or different agents to see what they're actually susceptible to. But what an absolute bonus having the opportunity to be able to identify the bug, and therefore the likely medications that would be beneficial for therapy within a two and a half hour period.
I think this is going to be a game changer. There's no question we will see this arrive because it's going to be incredibly beneficial. And although we may still do blood cultures so that we do get the benefit of matching up an organism with the medication that it actually responds to, this particular technology, because we will have good information about the antibiotic or therapy sensitivities of these bugs as we go into the process, I think that will give us great insight into what bug is there, therefore what our initial therapies are, and we can refine exactly what medication would be indicated based on culture response subsequently. But this will save lives. An absolutely fascinating bit of technology, one that I thought would be valuable to share. Watch this space, and I think we will be seeing it used more and more in time to come.
Well, I hope you found that interesting. I certainly did. I'm going to wish you the very best. If you do enjoy these podcasts, please subscribe and let other people know about them. For now though, until next time, I'm going to wish you the very best. Please live as well as possible for as long as possible. Take care and bye for now.
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