- Systemic illness caused by microbial invasion of normally sterile parts of the body is referred to as “sepsis.” This is a term that specifically serves to differentiate an illness of microbial origin from an identical clinical syndrome that can arise in several non-microbial conditions, of which pancreatitis is the archetype.
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Aug 17, 2021 · Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract.
- Who Is at Risk?
- Signs and Symptoms
- Common Causes
- Diagnosis and Clinical Management
- Sepsis and The Sustainable Development Goals
- Who Sepsis Response
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection (3). If not recognized early and managed promptly, it can lead to septic shock, multiple organ failure and death. It is most frequently a serious complication of infection, particularly in low- and middle-income countries where it represents a major cause of maternal and neonatal morbidity and mortality. In the community setting, sepsis often presents as the clinical deterioration of common and preventable infections. Sepsis also frequently results from infections acquired in health care settings, which are one of the most frequent adverse events during care delivery and affect hundreds of millions of patients worldwide every year (2). Healthcare-associated infections are often resistant to antibiotics and can rapidly lead to deteriorating clinical conditions. Antimicrobial resistance is a major factor determining clinical unresponsiveness to treatment and rapid evolution to sepsis and...
Anyone affected by an infection, severe injury, or serious non-communicable disease can progress to sepsis but vulnerable populations are at higher risk (4) including: 1. older persons, 2. pregnant or recently pregnant women, 3. neonates, 4. hospitalized patients, 5. patients in intensive care units, 6. people with HIV/AIDS, 7. people with liver cirrhosis, 8. people with cancer, 9. people with kidney disease, 10. people with autoimmune diseases, 11. and people with no spleen.
Sepsis is a medical emergency and can present with various signs and symptoms at different times. Warning signs and symptoms include: 1. fever or low temperature and shivering, 2. altered mental status, 3. difficulty breathing/rapid breathing, 4. increased heart rate, 5. weak pulse/low blood pressure, 6. low urine output, 7. cyanotic or mottled skin, 8. cold extremities, 9. and extreme body pain or discomfort (5-7). Suspecting sepsis is a first major step towards early recognition and diagnosis.
In 2017, the largest contributors to sepsis cases and sepsis-related mortality across all ages were diarrhoeal diseases (9.2 to 15 million annual cases) and lower respiratory infections (1.8-2.8 million annually) (1). However, non-communicable diseases are on the rise; one-third of sepsis cases and nearly half of all sepsis-related deaths in 2017 were due to an underlying injury or chronic disease (1). Maternal disorders were the most common non-communicable disease complicated by sepsis. Among children, the most common causes of sepsis-related deaths were neonatal disorders, lower respiratory infections, and diarrhoeal diseases (1). Group B streptococcus is the leading cause of both neonatal and maternal sepsis, though Escherichia coliis an emerging threat (8,9). Both of these pathogens have displayed considerable resistance to treatment and are considered priority pathogens for research and development (R&D) of new antibiotics. Sepsis Prevention There are two main steps to prevent...
Identifying and not underestimating the signs and symptoms listed above, along with the detection of some biomarkers (such as C reactive protein and procalcitonin), are crucial elements for early diagnosis of sepsis and the timely establishment of its appropriate clinical management. After early recognition, diagnostics to help identify a causal pathogen of infection leading to sepsis are important to guide targeted antimicrobial treatment. Once the source of infection is determined, source control, such as drainage of an abscess, is critical. Antimicrobial resistance (AMR) can jeopardize clinical management of sepsis because empirical antibiotic treatment is often required. Early fluid resuscitation to improve volume status is also important in the initial phase of sepsis management. In addition, vasopressors may be required to improve and maintain tissue perfusion. Repeated exams and assessments, including monitoring vital signs, guide the appropriate management of sepsis over time.
Sepsis is a significant cause of maternal, neonatal and child mortality. Consequently, combating sepsis will contribute to achievement of Sustainable Development Goals (SDGs) targets 3.8 on quality of care, and 3.1 and 3.2by improving mortality rates in these vulnerable populations. Sepsis can also ultimately lead to death in patients affected by HIV, tuberculosis, malaria, and other infectious diseases that are included in target 3.3. The prevention and/or appropriate diagnosis and management of sepsis is also linked to adequate vaccine coverage, quality universal health coverage, capacity to comply with the International Health Regulations, preparedness, and water and sanitation services. The challenge, however, remains how to achieve universal prevention, diagnosis and management of sepsis.
To combat this important global health threat, WHO responded with a WHO Secretariat Report and, in May 2017, the Seventieth World Health Assembly adopted Resolution WHA70.7 on Improving the prevention, diagnosis and clinical management of sepsis. The key pillars of Resolution WHA 70.7 are to: 1. Develop WHO guidance on sepsis prevention and management 2. Draw attention to public health impacts of sepsis and estimate the global burden of sepsis 3. Support Member States to define and implement standards and establish guidelines, infrastructure, laboratory capacity, strategies, and tools for identifying, reducing incidence of, and morbidity and mortality due to sepsis 4. Collaborate with UN organizations, partners, international organizations, and stakeholders to enhance sepsis treatment and infection prevention and control including vaccinations In collaboration and coordination with WHO regional offices, Member States and other stakeholders, several WHO headquarters programmes are cu...
(1) Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet (London, England). 2020;395(10219):200-11. (2) World Health Organization. WHO Report on the burden of endemic health care-associated infection worldwide. 2017-11-21 15:11:22 2011. (3) Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315(8): 801-10. (4) Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. British Medical Journal 2016. (5) United States Centers for Disease Control and Prevention. Healthcare Professional (HCP) Resources : Sepsis. Updated August 27, 2019. T06:23:15Z. https://www.cdc.gov/sepsis/get-ahead-of-sepsis/hcp-resources.html (accessed 25 February 2020). (6) Global Sepsis Alliance. Toolkits. https://www.world-sepsis-day.org/toolkits/ (accessed 25 Febru...
Oct 27, 2007 · What is sepsis? Systemic illness caused by microbial invasion of normally sterile parts of the body is referred to as “sepsis.” This is a term that specifically serves to differentiate an illness of microbial origin from an identical clinical syndrome that can arise in several non-microbial conditions, of which pancreatitis is the archetype.
- Andrew Lever, Iain Mackenzie
Feb 01, 2017 · Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The consensus document describes organ dysfunction as an acute increase in total Sequential Organ Failure Assessment (SOFA) score two points consequently to the infection.
- Fethi Gul, Mustafa Kemal Arslantas, Ismail Cinel, Anand Kumar
- Risk Factors
Sepsis is a potentially life-threatening condition that occurs when the body's response to an infection damages its own tissues. When the infection-fighting processes turn on the body, they cause organs to function poorly and abnormally. Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can lead to severe organ problems and death. Early treatment with antibiotics and intravenous fluids improves chances for survival.
Signs and symptoms of sepsis
To be diagnosed with sepsis, you must have a probable or confirmed infection and all of the following signs: 1. Change in mental status 2. Systolic blood pressure — the first number in a blood pressure reading — less than or equal to 100 millimeters of mercury (mm Hg) 3. Respiratory rate higher than or equal to 22 breaths a minute
Signs and symptoms of septic shock
Septic shock is a severe drop in blood pressure that results in highly abnormal problems with how cells work and produce energy. Progression to septic shock increases the risk of death. Signs of progression to septic shock include: 1. The need for medication to maintain systolic blood pressure greater than or equal to 65 mm Hg. 2. High levels of lactic acid in your blood (serum lactate). Having too much lactic acid in your blood means that your cells aren't using oxygen properly.
When to see a doctor
Most often, sepsis occurs in people who are hospitalized or who have recently been hospitalized. People in an intensive care unit are more likely to develop infections that can then lead to sepsis. Any infection, however, could lead to sepsis. See your doctor about an infection or wound that hasn't responded to treatment. Signs or symptoms, such as confusion or rapid breathing, require emergency care.
While any type of infection — bacterial, viral or fungal — can lead to sepsis, infections that more commonly result in sepsis include infections of: 1. Lungs, such as pneumonia 2. Kidney, bladder and other parts of the urinary system 3. Digestive system 4. Bloodstream (bacteremia) 5. Catheter sites 6. Wounds or burns
Several factors increase the risk of sepsis, including: 1. Older age 2. Infancy 3. Compromised immune system 4. Diabetes 5. Chronic kidney or liver disease 6. Admission to intensive care unit or longer hospital stays 7. Invasive devices, such as intravenous catheters or breathing tubes 8. Previous use of antibiotics or corticosteroids
As sepsis worsens, blood flow to vital organs, such as your brain, heart and kidneys, becomes impaired. Sepsis may cause abnormal blood clotting that results in small clots or burst blood vessels that damage or destroy tissues. Most people recover from mild sepsis, but the mortality rate for septic shock is about 40%. Also, an episode of severe sepsis places you at higher risk of future infections.