6.14.16 | Forbes.com
By Steve Brozak
To read the entire article on Forbes, please click here.
During his life, Muhammad Ali did many great things for a great many people. But he may still have another contribution to make to the public, or in this case, for the public’s health.
The cause of Ali’s death has been given as septic shock, not from Parkinson’s Disease, the condition that had stalked him the last 30 years of his life.
Sepsis is one of the deadliest killers of Americans. More people die of sepsis in the U.S. every year than AIDS, breast cancer and colon cancer combined. According to a federal study, it’s also the most expensive cause for hospitalizations in the U.S.
Sepsis can occur in anyone with a weakened immune system when a pathogen, either a fungus or bacteria, enters the bloodstream and sends the body’s major organs into shock. This could happen through a cut in the skin, an internal rupture of an organ or even through a patient’s PIC line in the hospital. Unable to fend off the infection, the pathogen overwhelms the blood, and the patient’s organs begin to basically shut down.
Sepsis spreads very rapidly through the body, so it is critical to identify the cause in a patient, whether fungal or bacterial, and administer the appropriate response before the sepsis is completely out of control for any chance of saving the patient.
Every hour of delay of the correct treatment increases mortality by 8%.
When patients present with sepsis, most physicians’ first move is to prescribe a broad spectrum of antibiotics while the patient’s blood culture test is processed, which could take one to five days. But if the sepsis is not caused by bacteria, the antibiotic treatment is utterly useless, and wastes precious hours as the infection rages on.
And, because giving an antifungal at the same time as an antibacterial could be toxic for the patient, the physician will have to wait hours, maybe days, before administering an antifungal drug.
Meanwhile you’ve just given a sick patient powerful antibiotics needlessly, increasing the potential for future resistance against a true bacterial infection.
According to the CDC, over one million Americans will be affected by sepsis, and 1.6 million will be hospitalized with the condition. Sepsis claims 258,000 lives each year. Nearly one third to one half of all hospital deaths in the U.S. are related to sepsis. There is evidence that more and more American lives are being claimed by sepsis each year. In fact, you are more likely to die of sepsis in America than you are to even encounter Ebola, Zika, West Nile virus, malaria or dengue fever combined.
The technology most hospitals rely on in their pathology labs to run blood culture tests are close to 90 years old and can take days to process. However, some hospitals are already beginning to utilize newer, faster technology like a platform device called the T2Dx.
Made by T2 Biosystems, Inc., the T2Dx is an FDA-cleared device that can rapidly detect and identify a blood infection in three to five hours, with rapid pinpoint screening of fungus-caused infections. That’s important because approximately 15% of healthcare-associated infections are caused by fungi, and 70-90% of all those infections are due to a family of fungus called Candida, which the T2 Biosystems device tests for. Eventually, T2’s device should be cleared to discern between various types of infections, including a test for detecting sepsis due to a bacterial infection.
American healthcare leadership is focused on the rise of drug-resistant bacteria and the ineffectiveness of antibiotics; antifungal medications have also been losing their potency. Later today, in fact, the U.S. Congressional Committee of Energy and Commerce is holding a hearing on the issue of combating drug resistance. They should also be asking about the increasing weakness of standard anti-fungal infection medications, which are also becoming more vulnerable to superbugs.
We have helped create superbugs because we misidentify infections and grossly misuse antibiotics and antifungals. Given the number of infections per year and the amount of drugs prescribed wantonly to treat patients, it is essential that the guesswork be taken out of the process of treating infections that cause sepsis. While there are several efforts to develop novel antibiotic and antifungal drugs, we still need to place better diagnostics in our hospitals to use our current arsenal accurately and wisely.
When patients receive the correct treatment quickly, they stand a better chance to survive and receive further treatment through the healthcare continuum. The benefits to the patient are obvious, but it also benefits all players in the market, including pharmaceutical giants like Merck and Pfizer, two of the largest manufacturers of antifungals and antibiotics.
The right drug utilized at the right time also means that there is less chance of exposing pathogens needlessly to critical drugs, thereby potentially decreasing their potency. Today, entire classes of antibiotic and antifungal drugs are losing their effectiveness because of their overuse in both humans and animals in the livestock industry.
What makes this striking is the fact that many of the major pharmaceutical companies have abandoned antibiotic and antifungal R&D.
After WWII, Pfizer was the established leader in antibiotic drug development, having provided penicillin for our troops. While Pfizer still makes several important antibiotic drugs, the company shut down its gram-negative antibiotic drug development campus in 2011. Sanofi, Eli Lilly and Bristol-Myers Squibb haven’t conducted significant R&D on antibiotics since the 90s. Instead, big pharma has focused resources on newer areas of medicine like immunotherapy (just as they did in the 1940s with antibiotics), along with other mainstays like statins, antidepressants and newer autoimmune/anti-inflammatory drugs. Antibiotics and antifungals are not as appealing financially, nor are they treatments for chronic diseases. For Big Pharma, that means an unsteady stream of income, and so most large drugmakers have bailed on those drug classes.
Today, smaller biotech companies are the major players aggressively developing newer antibiotics and antifungal medications.
When Muhammad Ali entered the hospital two weeks ago, the reported cause was respiratory problems. Within a couple days, he was gone; cause, septic shock.
We will probably never know what caused Muhummad Ali’s sepsis–or when it set in–but his death has brought momentary attention long overdue to an illness that has reached epidemic proportions in the U.S. Anyone who has seen a loved one suffer through septic shock knows how sudden and dreadful it can be.
Once it takes hold, sepsis can be very difficult to reverse, making it even more important to utilize the best technologies modern science can provide. In the future, that may include a combination of rapid-fire diagnostics like T2’s device and more conventional blood culture studies for a fuller view of the patient’s condition.
Hopefully during today’s congressional hearing, the panel will enter the ring and cover the broader issues we face with superbugs, and realize that part of dealing with this issue is to for the government to encourage adoption of modernized diagnostic technologies, and for hospitals to embrace them to better meet the needs of their patients.