Sepsis

How Sepsis Is Contracted

One of the reasons that sepsis can be so scary is that it can be caused by any infection of the body, even those that are not so apparent. Although sepsis is commonly caused by more severe infections such as a kidney infection or urinary tract infection, even an infected tooth can cause sepsis if left untreated.

Sepsis occurs when the bacteria from an existing infection causes systemic symptoms in the body. The immune system may be overwhelmed by the bacteria, causing more problems than solutions for patients. Sepsis in mild stages is relatively common. If left untreated or when the body does not respond to treatment, sepsis may become severe and turn to septic shock. In the event of septic shock, multi-organ failure and fatally low blood pressure may occur, leading to mortality in up to 40-50% of cases.

How Sepsis Is Treated

Sepsis is a common infection, frequently in the bloodstream, that may quickly turn deadly if not diagnosed and treated properly. There are two main treatments of sepsis. As sepsis is usually a bacterial (vs a viral infection), antibiotics are the first line of defense. In many cases, the antibiotics are usually administered through an IV. The choice of antibiotic is important, and are usually broad spectrum, meaning the antibiotic may work on many different kinds of infection.

With additional testing, usually a culture which takes several days, the antibiotic may narrow to a more specialized antibiotic targeting the specific infection for the individual. Individuals may also require IV fluids to support blood pressure and keep organs properly perfused. Low blood pressure from septic shock, a leading cause of death in sepsis, may require a second kind of drug (in addition to IV Fluids) called a vasopressor, a medication specifically designed to elevate blood pressure.

Are Peritonitis and Sepsis the Same?

Peritonitis is inflammation of the abdominal cavity. The infection can originate with a foreign body lodged in the abdomen which creates an infection, infections from other parts of the abdomen such as fallopian tubes or appendix, or outside causes such as surgical trauma. Sepsis indicates an infection causing systemic symptoms and usually occurs when bacteria from local reactions enter the bloodstream.

One reason the terms are often confused is peritonitis is sometimes called abdominal sepsis. Symptoms of sepsis are fever, increased breathing and heart rate and infection present in another part of the body, such as a urinary tract infection or an infected tooth.

Peritonitis symptoms include abdominal pain, may involve vomiting or diarrhea, dehydration and increased heart rate (so some overlap exists). Peritonitis, a localized infection, may proceed to sepsis. Both conditions may be difficult to diagnose. Peritonitis may be more difficult because the medical team frequently needs to collect a sample of the fluid from the abdominal cavity, whereas sepsis typically requires only a blood draw. Both conditions can be fatal if left untreated.

Are MRSA and Sepsis Patients Hospitalized?

MRSA is a resistant form of the bacteria Staphylococcus aureus (Methicillin-resistant Staphylococcus aureus). Patients with MRSA may or may not be symptomatic and may or may not need hospitalization. Some patients with MRSA are merely carriers and display no symptoms of illness and may not require treatment at all. However, if left untreated, certain MRSA infections may evolve into symptomatic infections and subsequently into sepsis, which may further progress to septic shock. Septic shock, the most severe form of sepsis, is lethal in up to 40% of cases.

Sepsis, by definition, is always symptomatic, and almost without exception requires medical treatment and hospitalization to cure. Sepsis occurs when an individual develops a localized infection in one part of the body which causes a systemic response in the body. People who have had recent surgery or who are currently fighting infection are at risk of sepsis.

Both of these conditions have a higher rate of occurrence in hospitalized patients. Hospital personnel traveling room to room interact with multiple ill patients every day and may serve as vectors for the spreading of these infections. Infection control efforts, including meticulous hand washing efforts and sterile cleaning of rooms at regular intervals, have decreased these occurrence rates.

What Are Sepsis and Asepsis?

Sepsis and asepsis are opposite terms. Sepsis is a clinical condition where a person has a systemic reaction to a bacterial infection from a localized infection in one part of the body, such as a wound or infected tooth. Sepsis, relatively common, can be treated with antibiotics, but when the body doesn’t respond to treatment options, the patient may enter septic shock, a progression of sepsis. Septic shock leads to death in up to 40% of cases.

Asepsis, on the other hand, is the normal state of not being in sepsis. Commonly used in pathology, asepsis indicates an individual is free of sepsis. For example, a patient suffering from sepsis who responds well to treatment will improve and eventually will return to the state of asepsis.

Sepsis 6

Sepsis 6 was a group of sepsis interventions pre-dating the sepsis bundles. The Sepsis 6 included all of the elements of the 3-hour bundle, including drawing a lactic acid, blood cultures, administering IV fluids and antibiotics. The other two elements, not specifically noted in the 3- or 6-hour bundle includes giving supplementary oxygen and commencing accurate urine output measurement. The success of the Sepsis 6 influenced development of our current sepsis bundles.

What Are Sepsis Markers?

Sepsis has a number of biomarkers, or measurable substances within the body, that medical professionals use to diagnosis and treat sepsis. Lactate levels are an important biomarker for sepsis and are included in the treatment bundles for sepsis. Other biomarkers that a medical team might look for when diagnosing and treating sepsis include pro-inflammatory cytokines, C-reactive protein (created by the body to fight infection), or monocyte activation.

Biomarkers are measured for aid in diagnosis and to see how the condition progresses and responds to treatment. For example, whether a particular biomarker is decreasing or increasing may help a physician know whether sepsis is improving or worsening. The physician may then increase or decrease IV fluids or may change antibiotics.

Sepsis Bundles

A sepsis “bundle” refers to a series of responses that a medical team takes in order to treat sepsis. There is a three-hour bundle and six-hour bundle, both of which include different steps, including specific testing, and administering IV fluids and antibiotics.

The purpose of the bundle is to make sepsis treatment more standardized for hospital teams to implement. The bundles were created by the Surviving Sepsis Campaign of the Society of Critical Care Medicine. The campaign has the goal of decreasing the amount of sepsis-related deaths by 25%. Individual hospitals can adjust protocols slightly to meet geographical differences in bacterial susceptibility to antibiotics, but the core of the bundles remain largely unchanged from hospital to hospital for simplicity and improved accuracy of treatment.

Sepsis Symptoms, Diagnosis, and Treatment

What are sepsis symptoms? 

Sepsis is a condition where an infection enters your blood and causes your body to have an overwhelming response to it. The infection is able to quickly travel all over your body and your immune system works over time to try to control it.

Sepsis has four main symptoms. The four main symptoms are:

  1. High fever (or abnormally low temperature)
  2. Rapid rate of breathing,
  3. Increased heart rate,
  4. Elevated WBC (white blood cell count)

Two of these four symptoms plus a source of infection meets the definition of sepsis. The symptoms of severe sepsis are more extreme and include extreme weakness, problems breathing, unconsciousness, chills, decreased urination, and organ failure. When left untreated, the body can enter septic shock, which couples all the above symptoms with dangerously low blood pressure.

How is sepsis diagnosed?

Sepsis can be difficult to diagnose but frequently needs rapid treatment to contain the infection and prevent progression into septic shock. An individual must present with at least two of the following four symptoms coupled with an existing infection somewhere in the body.

Blood tests may categorize the infection as either severe sepsis (more significant than simple sepsis) or septic shock (the most severe form of sepsis). Treatment of antibiotics and IV fluids may begin before results of the work up to prevent worsening of sepsis during definitive diagnosis occurs.

How sepsis is treated?

There are two main treatments of sepsis. As sepsis is usually a bacterial (vs a viral infection), antibiotics are the first line of defense. In many cases, the antibiotics are usually administered through an IV. The choice of antibiotic is important, and are usually broad spectrum, meaning the antibiotic may work on many different kinds of infection.

With additional testing, usually a culture which takes several days, the antibiotic may narrow to a more specialized antibiotic targeting the specific infection for the individual. Individuals may also require IV fluids to support blood pressure and keep organs properly perfused. Low blood pressure from septic shock, a leading cause of death in sepsis, may require a second kind of drug (in addition to IV Fluids) called a vasopressor, a medication specifically designed to elevate blood pressure. [SM2] 

Are Sepsis and Bacteremia the Same Thing?

Bacteremia and sepsis are often used interchangeably: however, they are different terms. Bacteremia is a term referring to the presence of bacteria inside an individual’s blood. In some situations, bacteremia doesn’t cause any symptoms and doesn’t necessarily represent a major danger to the afflicted. For example, there are likely bacteria released locally into the bloodstream each time we brush our teeth.

Sepsis is a clinical condition involving bacteria in the blood as well, which is why it is commonly confused with bacteremia. However, sepsis also has a clinical component and involves inflammation of the body with a range of other symptoms, such as fever, confusion and rapid breathing.