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04 February 2014

Gregor Czilwik - Rapid detection of sepsis in infants

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New detection methods could shorten the detection of sepsis from days down to only a few hours.

Sepsis is a possibly mortal bacterial infection. It affects neonates and young infants more severely since their immune system is not fully developed. Now scientists are developing a fully automated system, which can identify sepsis in infants within hours instead of days. Such performance in terms of sped is what the EU funded research project ASCMicroPlat hopes to deliver by the time its final tests have been conducted, in 2014. Gregor Czilwik, engineer of micro system technology and project manager at research institute HSG-IMIT in Freiburg, Germany, talks to about how this invention could both save lives and prevent the unnecessary use of antibiotics.

What does the technology developed during the project consist of?
It is a laboratory on a disc. Within the disc are very fine micro channels running outwards in a kind of star shape. By spinning the disc, we make centrifugal forces push a liquid—in this case a blood serum sample—through the micro channels. Liquids behave totally different in this micro world than in the real world. This is how we can identify what is in the liquid.

How are each of the blood serum samples analysed in the channels? 
We have in- built biochemical reactions which produce a kind of fluorescence light. By analysing this light we can tell what pathogen or bacteria are in the blood sample. It is up to twenty times faster than the present day methods, which need a blood sample to be cultured and only then analysed; the whole process can take up to five days.

What are the biggest challenges associated with your work? 
The subject itself is very complicated because there is a very low concentration of pathogens in each sample. So we need an extremely sensitive method to detect them. And, of course, we want a fully automated device. All the reagents in the disc must remain stable for a long time. And a laboratory technician should only need to apply a sample to the disc and push a button.

Our final design is more or less finished and we have already seen that we can detect bacteria. At the end of the project we will test the device to attempt to detect sepsis.

How are the tests going to be conducted?
Our project partner Trinity College Dublin has collected about 300 to 400 samples since the beginning of the project. Among those, 30 samples are positive. We will run them through our device and compare the results with the present day methods.

Is that enough?
Well, it is all we have. As a first start this is what we will have to do it with. But let’s face it, our test would, of course, not yet constitute the full clinical validation, at the end of our project.

Is this device about giving the infants treatment sooner, or rather about giving them the right type of medication? 
If a doctor has only the slightest suspicion an infant might be suffering from sepsis, they will always get broad spectrum antibiotics immediately. But with ASCMicroPlat you will quickly know if it really is sepsis. After all, sepsis can kill within hours, so even with our very fast method there is no time to waste. And, if sepsis has been detected, you will know what kind of pathogen you are dealing with. This way, antibiotics will not be administered unnecessarily. And if you do, you can be much more effective, giving exactly the right kind of antibiotic.

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