Pioneering research with sepsis patients helps fight superbugs

Desperately ill Scots have taken part in world-first research to help halt the growth of antibiotic-resistant superbugs.

A pioneering study involving patients at Dumfries and Galloway and Edinburgh Royal Infirmaries has allowed ICU specialists to identify vital recovery markers in blood which tell doctors when they can stop antibiotic ­treatment and limit the drugs’ use.

The breakthrough has been welcomed by young mum Rachel Flynn Charters, who had to endure several types of antibiotics to ­survive sepsis.

“I was not responding to treatment and doctors told me they had to eventually use heavy-duty antibiotics to save me,” she said.

Rise of antibiotic resistance

The rise in antibiotic resistance is a major concern to the world’s leading doctors.

However, the study by Professor Paul Dark looks at the markers in patients’ blood and is likely to lead to using fewer antibiotics. Overuse 
of these bacteria-busting drugs is driving the growth of superbugs.

It means doctors can end treatment sooner, cut back on the use of antibiotics and slow the rise of antibiotic-resistant superbugs.

Professor Dark, who worked previously in hospitals in Glasgow and Edinburgh, now heads up Critical Care at Manchester University.

He based his research on testing blood markers called procalcitonin (PCT) and C-reactive protein (CRP) in patients who were being treated for sepsis.

These markers fall when patients are responding to treatment, allowing doctors to tailor the antibiotics. PCT was shown to help doctors safely stop antibiotics early and CRP did not prove helpful. Professor Dark said: “The results show that we could reduce by 10% on the amount of antibiotics given to patients with sepsis.

“That might seem a small percentage, but multiply it by the huge numbers of people treated with ­antibiotics for sepsis worldwide and it’s considerable.

“The simple protocol we developed, if implemented, could significantly change the way sepsis is treated and safely help to combat antimicrobial overuse and resistance.

“That’s one of the world’s leading health challenges.

“It is also a powerful illustration of how precision medicine (targeted treatment) can make a real difference to patient care when treatment is tailored to individual test results of each patient.”

He praised the trial patients, adding: “It’s important to ­acknowledge that this study would not have been possible without the generous ­contribution of patients with this 
life-threatening condition.

“Like all of us, they are committed to finding better ways to deal with sepsis.”

The trial

The ADAPT-Sepsis trial enrolled patients from all over the UK.

Around 50,000 people die from sepsis in the UK every year, with a million deaths worldwide annually. Children and the elderly are most at risk. A House of Commons library report in October 2024 warned of the rising number of patients with antimicrobial infections.

Deaths due to severe antibiotic-resistant infections are increasing to well over 2,000 a year, the report added.

The global rise of super antibiotic-resistant bugs is being driven partly by the war in Ukraine, where military doctors are now reporting the spread of multi-resistance bacteria in ­casualties of the conflict.

This happens when bacteria learn to shield themselves from the drugs usually used to treat them and evolve into superbugs.

Professor Dark’s UK-wide study was funded by the National Institute of Health and Care Research.

It was a randomised controlled trial, comparing two groups of patients using either daily PCT or CRP tests, and also comparing both groups with patients treated with standard care – not using the daily marker tests.

More than 2,760 adults took part in the six-year study.

The pioneering research was a response to a call by the National Institute for Clinical Excellence urging doctors to seek better targeted antibiotics for suspected sepsis.

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‘The nurse told me I was so ill she was surprised I survived’

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Rachel Flynn Charters was only 25 when she became dangerously ill with sepsis.

It developed after a bladder infection progressed and threatened to take 
her life.

The communications officer from Penicuik, Midlothian, now works to support Scottish sepsis charity trust FEAT, named after Dr Fiona Elizabeth Agnew, who died from sepsis in pregnancy with her young daughter, Isla.

“I had felt ill for a while and been treated by my GP but the infection (also known as a urinary tract infection) never seemed to go away,” Rachel said.

“However, I ploughed on feeling exhausted but determined to join friends on a holiday to Spain.

“Just before the trip I felt so ill that I could barely walk, and my family rushed me to hospital.

“I was placed under the care of an ICU specialist and despite several courses of treatment, I deteriorated and had to be rushed to resuscitation twice.”

Doctors struggled to get Rachel’s body to respond to treatment and her family feared she would die.

She said: “Eventually, I improved but one of my nurses explained that they had to use seriously heavy-duty treatment to help me survive.

“The nurse then added that I was so ill, she was surprised that I did.”

Rachel welcomes Professor Dark’s research into tailored antibiotic use and its use in reining in the rise of superbugs resistant to antibiotics.

“My life was in the balance because I did not respond to commonly used antibiotics, and advances in precise but not overuse of these drugs is a huge advance,” she said.

Two years after her near-death ordeal she is now married to her then boyfriend Jordan, and they have a beautiful baby daughter, Raye.

“My family and Jordan would have been heartbroken if I had not survived, and I don’t want that for any other family,” she said.

“If you have signs of exhaustion, confusion, vomiting, high temperature, feeling cold, trouble breathing, please seek medical help immediately.”

Rachel required ‘heavy-duty’ treatment to ensure she lived. Inset, with daughter Raye.