13th,Sep is World Sepsis Day, The theme for the 13th World Sepsis Day is Sepsis Prevention: Save Lives, Stop Suffering. It is a global awareness event, highlighting the awareness of sepsis for both the medical fraternity and the local public about its early recognition and its prevention, thereby promoting quality of life.
Every year, 20 to 30 million patients suffer from sepsis worldwide, resulting in 11 million deaths. Based on the latest statistics and analysis of data from 195 countries around the world, American researchers found that one in five people in the world died from sepsis. Data released by the Global Sepsis Alliance showed that the number of deaths due to sepsis exceeded the total number of deaths from prostate cancer, breast cancer and AIDS.
Due to the low level of awareness of sepsis among medical staff and the public, not all sepsis patients can receive correct diagnosis and treatment, and the mortality rate of hospitalized patients is as high as 30% to 60%.
Let's get to know the Sepsis prevention to save lives and stop suffering!
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What is sepsis?
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What is the cause and pathogenesis of sepsis?
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What are the Clinical symptoms of sepsis?
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High-risk factors and populations for sepsis
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Diagnosis of sepsis
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Treatment of Sepsis
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Prevention of sepsis
What is sepsis?
Sepsis is a serious infectious disease caused by systemic inflammatory response syndrome (SIRS) after bacteria, fungi, viruses or other pathogenic microorganisms or their toxins invade the blood circulation. When the body gets infected, frequently beginning in the skin, gastrointestinal tract, urinary tract, or lungs, the immune system releases a large amount of chemicals to resist invading microorganisms. However, in sepsis, the immune response becomes overactivated, leading to uncontrolled SIRS, which may induce shock and affect multiple organs and systems throughout the body, including the cardiovascular system, respiratory system, digestive system, nervous system and coagulation system. In severe cases, it leads to multiple organ dysfunction, failure and even death, especially when it cannot be identified and treated early.
It is also called a killer lurking in the infection.
What is the cause and pathogenesis of sepsis?
the causes
Infections with bacteria, fungi, viruses (including SARS, COVID-19) and parasites cause systemic inflammatory responses, and the onset of the disease is related to the imbalance of the body's immune regulation.
- Basic causes
Sepsis can be caused by trauma or infection in any part of the body, such as pneumonia,
digestive system infection, peritonitis, multiple injuries, etc. Bacteria and toxins enter the
body, activate the body's inflammatory response cells, and produce inflammatory
mediators to cause inflammatory responses. Infections intensify and lead to immune
dysfunction, thus causing sepsis.
- Predisposing causes
Age factors, impaired immune system, history of diabetes or cirrhosis, intensive care unit treatment, trauma, etc.
The Pathogenesis
The fundamental pathogenesis of sepsis is not yet clear, involving complex systemic inflammatory network effects, genetic polymorphisms, immune dysfunction, abnormal coagulation function, tissue damage, and abnormal host responses to different infectious pathogens and their toxins.
In the early stage of systemic inflammatory response, lipopolysaccharide/endotoxin, etc., as pathogen-related molecular patterns, trigger infection and immune disorders in the body, mainly excessive inflammatory response characterized by high inflammatory cytokines, that is, the inflammatory storm stage. If the immune system can eliminate pathogens in time, immune balance can be quickly restored. If pathogens cannot be eliminated in time, immune disorders will continue, and the body will enter immunosuppression, immune failure, and even induce persistent inflammation-immunosuppression-catabolism syndrome.
What are the symptoms of sepsis?
Typical symptoms
Children, fever (>38.3℃ or <36℃), heart rate>90 beats/min, shortness of breath, respiration>20 times/min, mental status changes, obvious edema or positive fluid balance.
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Associated symptoms
Organ dysfunction (cardiovascular, pulmonary, brain, kidney), tissue hypoperfusion, hypotension, lactic acidosis, oliguria, acute changes in consciousness. Septic shock: sepsis symptoms, hypotension, impaired consciousness, weak and rapid pulse, cold and wet limbs, oliguria or anuria.
High-risk factors and Groups for sepsis
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Risk factors for sepsis
Anyone with infection and complications may develop sepsis, and anyone 
with the following risk factors is more likely to be infected with sepsis:
Old age or infants, immunosuppressive diseases, cancer, the use of immunosuppressants, diabetes, alcoholism, indwelling catheters or other damage to skin integrity leading to infection are all risk factors for sepsis.
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High-risk groups for sepsis:
Children under 1-2 years old, people over 65 years old, immunocompromised people, patients undergoing chemotherapy for tumors, and people with underlying diseases such as diabetes. For this group of people, if they have repeated high fevers after infection, poor spirits, rapid breathing and heartbeat, pale complexion, petechiae and ecchymoses on the skin, or reduced urine volume, they should all be highly concerned. At the same time, because its symptoms are both high fever, it should also be correctly identified with common influenza high fever to avoid misdiagnosis or missed diagnosis.
Diagnosis of sepsis
Sepsis is serious and difficult to treat, but early detection and appropriate treatment can improve outcomes for patients with sepsis.
The key to accurate diagnosis of sepsis: Early, accurate, and complete
The mortality rate of sepsis increases hourly, so time is crucial to the treatment of sepsis, and early identification of sepsis becomes the most critical part of treatment.
- Sepsis can generally be diagnosed by detecting inflammatory biomarkers such as white blood cells, high-sensitivity C-reactive protein(hs CRP), procalcitonin(PCT) and neutrophil ratio in the blood.
- Microbial culture has always been a routine etiological diagnostic technique for sepsis diagnosis and efficacy monitoring. However, clinical laboratories can generally only perform bacterial/fungal culture and cannot detect viruses, especially new and rare RNA viruses. It is also easy to miss species with low abundance or slow growth in some mixed infections.
- mNGS technology unbiasedly detects bacteria, fungi, viruses, parasites and other pathogens by extracting total nucleic acids (including human host nucleic acids and microbial nucleic acids) directly from clinical samples. Studies have shown that mNGS can be combined with blood culture and other methods It can significantly increase the pathogen detection rate (52%), and the positive coincidence rate between mNGS and blood culture is 93.7%. In the past two years, mNGS has been widely used in the diagnosis and treatment of sepsis and has been demonstrated in many aspects. It has been written into many clinical application consensuses.
Treatment of Sepsis
Sepsis is a critical illness, and timely treatment is extremely important. If the infection can be correctly diagnosed and treated within 1 hour, the patient's survival rate will reach more than 80%; if the infection is diagnosed and treated after 6 hours, the patient's survival rate will drop to 30%. Timely treatment can reduce the risk of death by half, and early sepsis treatment is less expensive and saves patients a lot of time in hospitalization and intensive care.
Prevention of sepsis
In recent years, despite the great progress in anti-infection treatment and organ function support technology, the mortality rate of sepsis is still as high as 30% to 70%.
The best way to prevent sepsis is to prevent infection first, which can be done in the following ways:
- Get timely vaccinations, especially for susceptible people;
- Pay attention to maintaining good living habits: wash hands frequently, drink clean water and food;
- Prevent hospital-acquired infections;
- Safe delivery;
- Strengthen awareness of sepsis.
Authough sepsis can be severe, we can protect ourselves by practicing good hygiene, staying up-to-date with vaccinations, managing chronic conditions, excercise regularily and recognizing the symptomes of sepsis. With early recongnition and timely treatment, there are fewer chances of organ damage or long-term disability.