Seeking a Killer
When Doctors Can't Wait
Results for the new test so far have been very promising, says
Alan Michelson, MD, professor of pediatrics and pathology at the University of
Massachusetts Medical School. "A test that could rapidly tell you whether
or not an infant is septic would save families a lot of trauma and a lot of
money," says Michelson, who isn't directly involved in the trials of the
sepsis test, but does other research involving CompuCyte. "There are a lot
of babies who wouldn't need intensive care treatment."
Naomi Williams couldn't agree more. After eight days of anguish
-- some spent sleeping in an unused recovery room in the hospital, some at home
without her newborn son -- she came closer to a breakdown than she'd ever
thought possible. At last, the couple was able to bring home a vigorous,
healthy Julian. But they still don't know if he ever had sepsis. Williams is
grateful to the hospital for the care they provided, and she knows it may well
have saved her son's life. Still, "this was the most traumatic experience
of our lives. But was it really necessary?" she wonders. "Wouldn't it
be great if you could find out sooner?"
"Everybody's still looking for the magic wand," says
Charles R. Rosenfeld, MD, director of the Division of Neonatal-Perinatal
Medicine at the University of Texas Southwestern Medical Center in Dallas.
"It must permit you to have very high specificity -- that is, few false
negatives -- and very high sensitivity, which would be few false
positives." While not familiar with the CompuCyte test, Rosenfeld cautions
that even with a 20-minute result, physicians still will be inclined to begin
treatment immediately. "You're still going to end up treating these kids in
the first 24 hours. Nobody in his right mind is going to wait for a test to
come back -- no matter how quickly -- if you think the baby's infected," he
Holzer agrees that doctors will, and should, proceed with
caution. "I think there will have to be very compelling data before
clinicians will change their practice," he says. "If they still feel,
in their clinical experience, that this infant is potentially septic, they'll
go ahead and treat. But the new test may allow them to have some confidence to
not treat certain babies, or to discontinue therapy sooner."
That alone would have been a godsend for Naomi Williams, who
struggled with breastfeeding an infant hooked up to machines and slept little,
if at all, throughout the eight days Julian was in intensive care. "When
you're in the hospital with this little helpless child that you've given birth
to, the fear is just awful," she says. "If we could have known sooner,
it would have been wonderful."
Gina Shaw is a Washington-based freelance writer who writes
frequently about health and medicine.