Definition Sepsis refers to a bacterial infection in the bloodstream or body tissues. This is a very broad term covering the presence of many types of microscopic disease-causing organisms. Description Sepsis is also called bacteremia. Closely related terms include septicemia and septic syndrome. In the general population, the incidence of sepsis is two people in 10,000. The number of deaths from sepsis each year has almost doubled in the United States since 1980 because more patients are developing the condition. There are three major factors responsible for this increase: a rise in the number of organ transplants and other surgical procedures that require suppressing the patient's immune system; the greater number of elderly people in the population; and the overuse of antibiotics to treat infectious illnesses, resulting in the development of drug-resistant bacteria. Causes and symptoms Sepsis can originate anywhere bacteria can gain entry to the body; common sites include the genitourinary tract, the liver and its bile ducts, the gastrointestinal tract, and the lungs. Broken or ulcerated skin can also provide access to bacteria commonly present in the environment. Invasive medical procedures, including dental work, can introduce bacteria or permit them to accumulate in the body. Entry points and equipment left in place for any length of time present a particular risk. Heart valve replacement, catheters, ostomy sites, intravenous (IV) or arterial lines, surgical wounds, or surgical drains are examples. IV drug users are at high risk as well. People with inefficient immune systems, HIV infection, spinal cord injuries, or blood disorders are at particular risk for sepsis and have a higher death rate (up to 60%); in people who have no underlying chronic disease, the death rate is far lower (about 5%). The growing problem of antibiotic resistance has increased the incidence of sepsis, partly because ordinary preventive measures (such as prophylactic antibiotics) are less effective. Cancer patients are at an increased risk of developing sepsis because chemotherapy and other forms of treatment for cancer weaken their immune systems. The most common symptom of sepsis is fever, often accompanied by chills or shaking, or other flu-like symptoms. A history of any recent invasive procedure or dental work should raise the suspicion of sepsis and medical help should be sought. Diagnosis The presence of sepsis is indicated by blood tests showing particularly high or low white blood cell counts. The causative agent is determined by blood culture. In some cases the doctor may order imaging studies to rule out pneumonia, or to determine whether the sepsis has developed from a ruptured appendix or other leakage from the digestive tract into the abdomen. Treatment Identifying the specific causative agent ultimately determines how sepsis is treated. However, time is of the essence, so a broad-spectrum antibiotic or multiple antibiotics will be administered until blood cultures reveal the culprit and treatment can be made specific to the organism. Intravenous antibiotic therapy is usually necessary and is administered in the hospital. The patient's chances of survival are increased by rapid admission to an intensive care unit followed by aggressive treatment with antibiotics. KEY TERMS - Bacteremia
- The medical term for sepsis.
- Prophylactic
- Referring to medications or other treatments given to prevent disease.
For Your Information Resources Books - Beers, Mark H., MD, and Robert Berkow, MD., editors. "Bacteremia and Septic Shock." Section 13, Chapter 156 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.
Periodicals- Cunha, Burke A., MD. "Sepsis, Bacterial." eMedicine September 29, 2004.
- Koranyi, K. I., and M. A. Ranalli. "Mycobacterium aurum Bacteremia in an Immunocompromised Child." Pediatric Infectious Diseases Journal 22 (December 2003): 1108-1109.
- Larche, J., E. Azoulay, F. Fieux, et al. "Improved Survival of Critically Ill Cancer Patients with Septic Shock." Intensive Care Medicine 29 (October 2003): 1688-1695.
- Paphitou, N. I., and K. V. Rolston. "Catheter-Related Bacteremia Caused by Agrobacterium radiobacter in a Cancer Patient: Case Report and Literature Review." Infection 31 (December 2003): 421-424.
- Petrosillo, N., L. Pagani, G. Ippolito, et al. "Nosocomial Infections in HIV-Positive Patients: An Overview." Infection 31, Supplement 2 (December 2003): 28-34.
- Wall, B. M., T. Mangold, K. M. Huch, et al. "Bacteremia in the Chronic Spinal Cord Injury Population: Risk Factors for Mortality." Journal of Spinal Cord Medicine 26 (Fall 2003): 248-253.
Organizations- American College of Epidemiology. 1500 Sunday Drive, Suite 102, Raleigh, NC 27607. (919) 861-5573.
- American Public Health Association (APHA). 800 I Street NW, Washington, DC 20001-3710. (202) 777-APHA.
- Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311.
Other- "Supportive Care for Patients-Fever, Chills, and Sweats." National Cancer Institute CancerNet 16 April 16, 2001.
Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group
The Essay Author is Jill S. Lasker.
This article was updated on 08-14-2006
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