Authors' results and conclusions: The gold-standard for diagnosing sepsis blood culture, takes several days and may be unreliable, and broad spectrum antibiotics are frequently used to target all potential organisms. This introduces risks of overtreatment, toxicity, and selection of bacteria resistant to a range of antimicrobial therapies. Alternative methods to diagnose sepsis, and detect the pathogen(s) responsible, include the application of magnetic resonance to exploit the supramagnetic properties of particles with specific-target binding affinities (technology trade name T2Candida) and polymerase chain reaction/electrospray ionization-mass spectrometry technology (trade name IRIDICA). These technologies are marketed as tools to improve the speed at which sepsis can be diagnosed and avoid the potential risks associated with broad-spectrum antibiotic/antifungal treatment/overtreatment. Low to intermediate level evidence was identified suggesting that the potential benefits and disadvantages of both IRIDICA and T2Candida require further investigation. The evidence base for both technologies is immature and diagnostic data that better replicate potential use of the technology in clinical practice are warranted. Randomised trial data that capture important outcomes such as changes to patient management as a result of using these technologies rather than the established methods (blood culture or empirically directed treatment regimens), and morbidity and mortality outcomes are desirable to inform decision making.

Authors' recommendations: There is an urgent need for a diagnostic test to enable the rapid identification and diagnosis of sepsis, especially in patients presenting to emergency departments. The T2Candida test reported good sensitivity and specificity, however, given the low incidence of candida septicaemia, it is unlikely to be cost-effective. HealthPACT noted that the T2Candida test would be efficacious in some immuno-compromised and oncology patients, however, its need in clinical practice is likely to be minimal. No further research on the T2Candida test on behalf of HealthPACT is warranted at this time. The evidence-base for rapid sepsis tests such as the IRIDICA remains immature. HealthPACT does not support public investment in technologies such as this in clinical practice at this time and recommends that an overview of all sepsis detection technologies commissioned.

Project Status: Completed

Year Published: 2016

URL for published report: Not Available

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Adelaide Health Technology Assessment

Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617

Contact Name: ahta@adelaide.edu.au

Contact Email: ahta@adelaide.edu.au

Copyright: Adelaide Health Technology Assessment (AHTA)