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- Elizabeth McMahon
A closer look at sepsis testing, from the latest in detecting and diagnosing the deadly disease to understanding its impact on children. Plus, some good news on tuberculosis testing. These stories and more next. This is the Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Thursday, March 26th. We begin this morning with a special report on sepsis, the body's extreme reaction to an infection and a leading cause of death worldwide. Detecting and diagnosing sepsis can be challenging since the syndrome has many characteristics, making infection hard to confirm. The latest issue of CAP Today looks at the landscape in sepsis biomarkers and tests with Dr. Christopher Farnsworth, Medical Director of Clinical Chemistry and point-of-care testing at Barnes-Jewish Hospital in St. Louis. Dr. Farnsworth reviews several studies of sepsis diagnostics, noting their advantages and limitations. Quote, I don't think we're in a place where we can say which assay is best, Dr. Farnsworth says. Find his full overview at CAP today. JAMA Network has released national estimates of pediatric sepsis in a study of more than 3.9 million U.S. hospital records. Noting that pediatric sepsis has been difficult to measure due to variations in accuracy and coding practices, the team, led by researchers from the Harvard Pilgrim Healthcare Institute, developed a pediatric sepsis event definition to examine data between 2016 and 2023. They found sepsis in 1.3% of pediatric hospitalizations, and in 17.8% of hospitalizations that ended in death. The data corresponds to more than 18,000 U.S. cases and more than 1,800 pediatric sepsis deaths annually. When patients have confirmed or suspected sepsis, they may require a procalcitonin test to help determine their treatment. It's a commonly misapplied test, But but the CAP's test ordering program provides essential information on procalcitonin and many other tests to support responsible lab stewardship. The program's test modules give you expert-led and reviewed content to bolster your understanding of the latest recommendations. One of those experts is Dr. Elizabeth Weinzierl, a member of the CAP's Quality Practices Committee. In an occasional series exploring the test modules, Dr. Weinzierl you chief of pathology and laboratory medicine at Children's Healthcare of Atlanta, discussed procalcitonin testing fundamentals.
- Dr. Elizabeth Weinzierl
The FDA has approved its use in a few situations. So those are, you know, risk assessment of critically ill patients on the first day of ICU admission for progression to severe sepsis or septic shock. So that can be really a risk stratification tool. It can also be used... in the setting of lower respiratory tract infections, there's enough data out there that it can be used to make determinations to start or stop antibiotics. And that uses specific cutoff values. And then in suspected sepsis, it can also help the decision-making process in discontinuing those antibiotics in patients with confirmed or suspected sepsis.
- Elizabeth McMahon
Dr. Weinzierl emphasized that procalcitonin testing is never 100% sensitive or specific and should not be used as a standalone test.
- Dr. Elizabeth Weinzierl
It can be elevated in the setting of some other non-bacterial causes, and physicians should be aware of that. You know, trauma, certain malignancies, even newborns, especially in the very early stages, the first few days of infancy, they will have a naturally high level of procalcitonin. It can be elevated in chronic kidney disease when you're not clearing. It can be elevated in shock. It can be elevated in cirrhosis. So you really have to take this whole clinical picture into consideration when we're using it.
- Elizabeth McMahon
A benefit of procalcitonin testing is its role in responsible antibiotic stewardship, Dr. Weinzierl says.
- Dr. Elizabeth Weinzierl
That's a really important thing that we all have to be aware of and actively work towards. It doesn't necessarily... reduce, it's not going to affect necessarily mortality, but it can certainly reduce unnecessary drug exposure. So if you can really take, you know, 48 hours off of a patient's exposure to antibiotics, you're performing a valuable service there both for the patient and for society and, you know, reducing the potential evolution of antibiotic resistant drugs.
- Elizabeth McMahon
Learn more about procalcitonin testing and test modules in chemistry, microbiology, immunology, and others at the Test Ordering Program tab on the CAP's Laboratory Improvement page. And finally, some good news in global health from UC Davis. That's where Dr. Imran Khan, a professor in the Department of Pathology and Laboratory Medicine, leads a research team that's developed a new tuberculosis blood test that can detect the active infectious form of the disease. Current TB tests don't differentiate between active and inactive TB. The research team evaluated the test in a clinical trial of more than 600 people in India between 2019 and 2023. The test performed well in adult pulmonary TB and identified harder-to-detect TB cases in children. The team is awaiting approval for the test by the Indian Council of Medical Research. In 2024, about 1.23 million people worldwide died from TB. That's all for The Daily Edition. Be sure to check the show notes for more information on today's stories. Watch your inbox for more news like this in the CAP's advocacy newsletter every Tuesday and our weekly edition newsletter on Thursdays. We're back at 5 a.m. Eastern for another episode of The Daily Edition. I'm Elizabeth McMahon. Have a great day.
Description
Transcription
- Elizabeth McMahon
A closer look at sepsis testing, from the latest in detecting and diagnosing the deadly disease to understanding its impact on children. Plus, some good news on tuberculosis testing. These stories and more next. This is the Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Thursday, March 26th. We begin this morning with a special report on sepsis, the body's extreme reaction to an infection and a leading cause of death worldwide. Detecting and diagnosing sepsis can be challenging since the syndrome has many characteristics, making infection hard to confirm. The latest issue of CAP Today looks at the landscape in sepsis biomarkers and tests with Dr. Christopher Farnsworth, Medical Director of Clinical Chemistry and point-of-care testing at Barnes-Jewish Hospital in St. Louis. Dr. Farnsworth reviews several studies of sepsis diagnostics, noting their advantages and limitations. Quote, I don't think we're in a place where we can say which assay is best, Dr. Farnsworth says. Find his full overview at CAP today. JAMA Network has released national estimates of pediatric sepsis in a study of more than 3.9 million U.S. hospital records. Noting that pediatric sepsis has been difficult to measure due to variations in accuracy and coding practices, the team, led by researchers from the Harvard Pilgrim Healthcare Institute, developed a pediatric sepsis event definition to examine data between 2016 and 2023. They found sepsis in 1.3% of pediatric hospitalizations, and in 17.8% of hospitalizations that ended in death. The data corresponds to more than 18,000 U.S. cases and more than 1,800 pediatric sepsis deaths annually. When patients have confirmed or suspected sepsis, they may require a procalcitonin test to help determine their treatment. It's a commonly misapplied test, But but the CAP's test ordering program provides essential information on procalcitonin and many other tests to support responsible lab stewardship. The program's test modules give you expert-led and reviewed content to bolster your understanding of the latest recommendations. One of those experts is Dr. Elizabeth Weinzierl, a member of the CAP's Quality Practices Committee. In an occasional series exploring the test modules, Dr. Weinzierl you chief of pathology and laboratory medicine at Children's Healthcare of Atlanta, discussed procalcitonin testing fundamentals.
- Dr. Elizabeth Weinzierl
The FDA has approved its use in a few situations. So those are, you know, risk assessment of critically ill patients on the first day of ICU admission for progression to severe sepsis or septic shock. So that can be really a risk stratification tool. It can also be used... in the setting of lower respiratory tract infections, there's enough data out there that it can be used to make determinations to start or stop antibiotics. And that uses specific cutoff values. And then in suspected sepsis, it can also help the decision-making process in discontinuing those antibiotics in patients with confirmed or suspected sepsis.
- Elizabeth McMahon
Dr. Weinzierl emphasized that procalcitonin testing is never 100% sensitive or specific and should not be used as a standalone test.
- Dr. Elizabeth Weinzierl
It can be elevated in the setting of some other non-bacterial causes, and physicians should be aware of that. You know, trauma, certain malignancies, even newborns, especially in the very early stages, the first few days of infancy, they will have a naturally high level of procalcitonin. It can be elevated in chronic kidney disease when you're not clearing. It can be elevated in shock. It can be elevated in cirrhosis. So you really have to take this whole clinical picture into consideration when we're using it.
- Elizabeth McMahon
A benefit of procalcitonin testing is its role in responsible antibiotic stewardship, Dr. Weinzierl says.
- Dr. Elizabeth Weinzierl
That's a really important thing that we all have to be aware of and actively work towards. It doesn't necessarily... reduce, it's not going to affect necessarily mortality, but it can certainly reduce unnecessary drug exposure. So if you can really take, you know, 48 hours off of a patient's exposure to antibiotics, you're performing a valuable service there both for the patient and for society and, you know, reducing the potential evolution of antibiotic resistant drugs.
- Elizabeth McMahon
Learn more about procalcitonin testing and test modules in chemistry, microbiology, immunology, and others at the Test Ordering Program tab on the CAP's Laboratory Improvement page. And finally, some good news in global health from UC Davis. That's where Dr. Imran Khan, a professor in the Department of Pathology and Laboratory Medicine, leads a research team that's developed a new tuberculosis blood test that can detect the active infectious form of the disease. Current TB tests don't differentiate between active and inactive TB. The research team evaluated the test in a clinical trial of more than 600 people in India between 2019 and 2023. The test performed well in adult pulmonary TB and identified harder-to-detect TB cases in children. The team is awaiting approval for the test by the Indian Council of Medical Research. In 2024, about 1.23 million people worldwide died from TB. That's all for The Daily Edition. Be sure to check the show notes for more information on today's stories. Watch your inbox for more news like this in the CAP's advocacy newsletter every Tuesday and our weekly edition newsletter on Thursdays. We're back at 5 a.m. Eastern for another episode of The Daily Edition. I'm Elizabeth McMahon. Have a great day.
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