Understanding the clinical pathway for early-stage point-of-care testing of Sepsis

Sepsis is a poorly understood, complex condition, affecting those of all ages, whose progression is difficult to predict and whose outcome can frequently be fatal. With the possibility for rapid deterioration in a patient’s condition, early identification of Sepsis is essential to improve patient outcomes and improve post-illness quality of life. The objective of this proposal is to build an improved understanding of the clinical testing pathway for early identification of Sepsis and further evaluate the suitability of a clinically relevant test that enables rapid testing at the point-of-care (POC) to advise critical clinical decision-making when treating this condition in an Emergency Department (ED). To develop a genuinely game-changing test, it is essential to bring together the appropriate clinicians and technologists to pinpoint the various testing needs and limitations, and to then deliver an appropriate POC test. Therefore, the proposal aims to develop and sustain a strategic partnership between the investigators across the disciplines of photonics engineering, microbiology, and clinical medicine at the University of Southampton (UoS), University Hospital Southampton NHS Foundation Trust (UHS-NHS), National Microbiology Reference Laboratory (NMRL), Uganda and Sri Devraj Urs Medical College (DUMC), India. Through strategic placements of the UK-investigators, primarily the UoS-based Project Lead (PL): a laser-physicist, within the ED and associated testing laboratory of UHS-NHS, NMRL and DUMC, and the UHS-NHS-based Project Co-Leads (PcLs): an Intensive Care Consultant and a Consultant Medical Microbiologist, for a limited period within NMRL and DUMC, the proposal aims to build a better understanding to address an unmet challenge of configuring and delivering a sepsis-diagnostic, which is equally well-positioned for use in hospitals with different resources and infrastructure. A diagnostic that provides a rapid result delivers a potentially invaluable benefit of saving the lives of those admitted to ED with Sepsis. This invaluable training within different healthcare settings, especially an ED and the associated testing laboratory, will help the PL, as mentioned in the Call: ‘Gain skills and knowledge to answer a specific cross-disciplinary research question’ – rapid POC testing for Sepsis. ‘Understand the drivers for that research challenge and the context in which any solution would be deployed’ – triaging and early diagnosis in hospital EDs. ‘Better identify the healthcare challenges and clinical workflows’ – within ED and testing lab, ‘where EPS (-based PL) has the potential to lead to novel solutions’ - a rapid test for early identification of Sepsis and patient stratification into appropriate treatment units. ‘Broaden their (PL’s) awareness of the current state-of-the art in other scientific (clinical diagnostics) disciplines that are needed to address the research challenge’ – of developing a test routinely employable within hospital EDs for Sepsis. Similarly, the proposed short visits will enable the PcLs to, as stated in the Call: ‘Understand the drivers for that research challenge and the context (lower- and middle-income country, LMIC) in which any solution would be deployed’ – i.e., in comparatively resource-constrained settings of an ED at hospitals in LMICs. ‘Understand the social science and design factors (in a LMIC) that influence the adoption and use of healthcare technologies and patient concordance’ - in LMICs. Finally, both the above will facilitate to ‘strengthen or build new collaborations (between the UK-investigators and those in the LMICs) and carry out broader multi-centre research within health technologies with the collaborators’ towards the end-goal of tackling Sepsis.