When a Wound Gets Infected
A recent scientific publication estimated that in 2017 there were 48.9 million cases and 11 million sepsis-related deaths worldwide, which accounted for almost 20% of all global deaths
What is wound infection?
It is an infection of a wound caused by physical injury of the skin as a result of penetrating trauma. The skin represents a defence barrier. Wounds break the continuity of the skin and allow organisms to gain access to underlying tissue and cause infection. Infections arising in surgical and burn wounds are one of the most common hospital-acquired infections and are an important cause of morbidity and mortality.
A lot of organisms, like bacteria, viruses and fungal parasites, can be responsible for skin infections. The most common organisms associated with wound infections include Staphylococcus aureus/MRSA, Escherichia coli, Klebsiella pneumoniae, Candida and Pseudomonas aeruginosa.
Diagnosis and treatment of wound infections and sepsis
The diagnosis of wound infection is usually based on wound examination, infection biomarker detection, and microbiological analysis.
Bloodstream infections may lead to sepsis. Sepsis is one of the top 5 diagnoses for adult admission in the ICU.
In the absence of species-specific diagnostic information, clinical treatment of sepsis begins with the initiation of empiric therapy. Despite the broad coverage of empiric therapy, it may not adequately address all organisms. A study published in 2021 (1) suggests that 1 in 5 patients with bloodstream infections receive inappropriate treatment, that is associated with increased odds of mortality. Fast, targeted antimicrobial therapy is especially important for patients in septic shock, whose mortality risk increases by 8% for every hour of delayed appropriate treatment (2).
The challenge medical practitioners and hospitals face is the time it takes to identify the organisms causing the infection and then prescribing the correct treatment. Traditionally a blood culture test is done to identify what type of bacteria or fungi causes infection in the blood. They are usually taken more than once from different veins and it can take several days to get the results of a blood culture consequently delaying the change from empiric therapy to targeted therapy.
Revolutionary new diagnostics for the detection of wound infections
New developments in technology now provide medical practitioners and hospitals the prospect to improve wound infection morbidity and mortality.
T2 Magnetic Resonance Therapy (T2MR) is a diagnostic detection method utilizing miniaturized magnetic resonance technology that measures how water molecules react in the presence of magnetic fields. T2MR can quickly and accurately identify molecular targets within patient samples without the need for purification or extraction of target molecules from the sample. Species identiﬁcation is done directly from a 4mL draw of whole blood, with proven high sensitivity and speciﬁcity. T2MR thus eliminates time- and labour-intensive steps. The T2MR diagnostic signal is not compromised or disrupted by the sample background, even for highly complex sample backgrounds present in blood from patients suspected of having sepsis.
The benefits of T2MR include:
- Target therapy sooner by reducing the time to species ID. T2Bacteria was shown to identify targeted species of bacteria approximately 66 hours faster than blood culture and 40% of subjects in the clinical trial may have benefited from the initiation of or a change in therapy 2-days faster with a T2Bacteria result as compared to blood culture alone.
- Increase clinician confidence in treatment with accurate and reliable results as unlike blood culture, T2MR Technology is not susceptible to interference from common antimicrobials.
- Impact patient outcomes and reduce length of stay for patients with bloodstream infections as T2MR has demonstrated a 5-day reduction intensive care unit (ICU) stay and a 4.8-day reduction in hospital length of stay.
- Improve antimicrobial stewardship. T2MR provided the opportunity to escalate or de-escalate therapy sooner and therefore has the potential to reduce the overuse of antimicrobials and limit side-effects.
- Indicate resistance to common empiric antibiotic therapies such as carbapenems, vancomycin, penicillin and more within 3-5 hours.
- Kadri SS, Lai YL, Warner S, et al, Inappropriate empirical antibiotic therapy for bloodstream infections based on discordant in-vitro susceptibilities: a retrospective cohort analysis of prevalence, predictors, and mortality risk in US hospitals. Lancet Infect Dis. 2021.
- Kumar, A., et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical Care Medicine. 2006.