Sepsis

Sepsis is the body's reaction to an infection and may be more or less severe. However, the responsible infectious agent (bacteria, virus, fungus, or parasite) is identified in only 50 to 70% of cases. Although sepsis may develop from any type of infection, the ones that most frequently cause the disease are bronchopulmonary (40%), abdominal (30%), and urinary tract (10%) infections.

Public health impact

Sepsis is the leading cause of death in intensive care units. Mortality at one month depends on the severity of the condition (see below): 20% for sepsis, 40% for severe sepsis, and 50 to 60% for septic shock. Each year, 1,500 people per million contract sepsis, which is the cause of 1% of all hospitalizations. Twelve percent of hospital patients in intensive care present severe sepsis and 9% septic shock.

Diagnosis

Depending on the severity of the condition, it is classified in one of three groups: sepsis, severe sepsis, and septic shock. (in increasing order of severity)
-Clinical signs: fever or hypothermia, accelerated heartbeat and respiration. Severe sepsis results in low blood pressure and poor blood flow to organs (kidney, liver, brain, etc.), causing organ dysfunction. Septic shock may be distinguished from severe sepsis by low blood pressure that continues for more than one hour even though adequate treatment has been given.
-Additional examinations: Medical imaging and other tests aim to identify the origin of the infection (chest x-ray, sinus x-ray, ultrasound of abdomen, etc.), and evaluate the effects on the organs (liver, kidney, etc.) and on coagulation.
-Biological analyses: Biological analyses are decisive; they are used to identify the infectious agent at the root of the infection and, if necessary, determine its antimicrobial resistance profile. Bloodculture is a key examination that must be performed under optimum conditions to have the best possible chance of detecting the bacteria/yeast responsible for infection. Beginning effective antibiotic therapy as early as possible also plays a decisive role on the outcome of the disease. Taking bacteriological samples (from the wound; throat; urine and stool samples) is determined by clinical signs and medical imaging, and may also involve more invasive sampling : bronchial aspiration, lumbar puncture (spinal tap), cerebro-spinal fluid, etc.