Code Sepsis: Rapid Methods To Diagnose Sepsis and Detect Hematopathogens. Part II: Challenges to the Laboratory Diagnosis of Sepsis

Bloodstream infections and sepsis are among the top causes of mortality in the United States, killing nearly 600 people per day. Many septic patients are treated in emergency medicine departments or critical care units, settings in which rapid administration of targeted antibiotic therapy drastically reduces mortality. Unfortunately, current microbiology laboratory methods are too slow to support rapid interventions, typically requiring >24 hours to detect the presence of bloodstream pathogens (hematopathogens) and at least 3 to 5 days to confirm the selection of appropriate antimicrobial therapy. Moreover, cultures from septic patients are often falsely negative due to pre-emptive therapy, the presence of fastidious organisms, or microbes that are present in low density. As a result, empiric, broad-spectrum treatment is common, a costly approach that may fail to effectively target the correct microbe, may inadvertently harm patients via antimicrobial toxicity, and may contribute to the evolution of drug-resistant microbes. Clearly, new rapid laboratory methods, which enhance laboratory capabilities to diagnose bloodstream infections, will be a useful and welcome addition to clinical microbiology laboratories.