Sepsis

Sepsis is a serious systemic * infection caused by bacteria in the bloodstream.

What Is Sepsis?

* that provoke a response by the body's immune system * . The effect of the toxins combined with the response of the immune system brings about the disease. Bacteremia may resolve by itself, or it can lead to sepsis if the bacteria are not removed by the immune system. Although bacteremia and sepsis frequently coexist, each can be present without the other. The bacteria may come from a local infection, such as pneumonia * or a urinary tract * infection; or they may come from the nose, skin, or intestines * , where bacteria live without causing problems unless they enter the bloodstream. The most common sources of infection that lead to sepsis are the lungs, skin, intestine, urinary tract, and gallbladder * .

Sepsis is most dangerous to people with weak immune systems, such as infants, the elderly, people with HIV/AIDS or cancer, or those who have undergone organ transplantation. In infants younger than three months, any fever may be a sign of sepsis or another serious infection. Doctors advise immediate evaluation of these infants and prompt treatment with antibiotics when sepsis is suspected. Group B streptococcus (strep-tuh-KAH-kus) bacteria passed from mother to baby during birth are a major cause of sepsis in infants. Streptococcus pneumoniae (strep-tuh-KAH-kus nu-MO-nye) and Neisseria meningitidis (nye-SEER-e-uh mehnin-jih-TIH-dis) bacteria are associated with sepsis in older children and in adults. Sepsis in adults is most often seen after surgery or some other medical procedure in the hospital, but it may occur outside the hospital, particularly with urinary tract infection.

How Common Is Sepsis?

Sepsis is not very common. According to the National Library of Medicine, sepsis develops in about two of every 10,000 people in the general population. In infants, sepsis occurs in fewer than one to two per 1,000 live births. Sepsis is a complication in about two of every 100 hospitalizations, where related intravenous * (IV) lines, surgical wounds or drains, and bedsores * can be entry points for bacteria.

Is Sepsis Contagious?

Sepsis itself is not contagious, but the infectious agents that can cause sepsis can be transmitted from person to person. For example, in newborns, group B streptococcus organisms can spread from mother to baby during delivery.

What Are the Signs and Symptoms of Sepsis?

Early symptoms of sepsis may include fever, shaking chills, rapid breathing and heartbeat, confusion, delirium * , and rash. As the infection spreads, a person's blood pressure drops, leading to a condition known as shock * . Body organs that have important functions, including the liver, lungs, and kidneys, may begin to shut down. The blood clotting * system may also be affected. Sepsis in young children may be more difficult to diagnose at first because it has fewer obvious symptoms. Children may have a fever or fluctuating temperature, a change in heart rate, or difficulty breathing. They might also be irritable or sluggish, and they may lose interest in eating.

How Do Doctors Diagnose Sepsis?

A diagnosis of sepsis is made based on a person's symptoms. Blood tests are performed to identify the bacteria and to look for a low platelet * count (an indicator of the blood clotting problems seen with sepsis) and an abnormally low or high white blood cell count (both of which can occur with sepsis). Other tests can help show damage to vital organs such as the kidneys.

How Do Doctors Treat Sepsis?

As soon as a diagnosis of sepsis is suspected, treatment with intravenous antibiotics begins. Patients with sepsis are hospitalized in an intensive care unit, where they may be given oxygen, intravenous fluids, and medication to stabilize blood pressure, treat other symptoms, and kill the bacteria responsible for the condition. Dialysis * may be necessary if the patient's kidneys fail. If respiratory failure * occurs, patients usually are placed on a ventilator, a machine that aids their breathing until they can breathe again on their own. If the patient survives, recovery from sepsis can take weeks.

What Are the Complications of Sepsis?

Septic shock * may occur in patients with sepsis. Disseminated intravascular coagulation is a complication associated with sepsis in which the body's blood clotting system is out of control, a problem that can lead to serious internal bleeding. This complication usually improves when the cause of sepsis is treated. Sepsis can be fatal, depending on the infectious agent and on the age and overall health of the patient. Quick diagnosis and treatment can improve outcomes and save lives.

How Is Sepsis Prevented?

Sepsis may not be preventable in many cases, but an early response to symptoms may stop a bacterial infection from progressing to sepsis. Early treatment is particularly important with regard to people with weak immune systems. Among hospitalized patients, efforts are made to limit the use of intravenous and urinary catheters * , which are both common entry points for sepsis-causing bacteria. Following a recommended vaccination * schedule for children can lessen their risk of contracting certain infections that might lead to sepsis. Immunization against Streptococcus pneumoniae is recommended for infants and for adults and children at high risk due to age or medical problems. This vaccine is highly effective in preventing pneumonia and sepsis caused by this organism.

Pregnant women typically are tested to determine whether they are carrying group B streptococcus bacteria in their vagina * . Treating these women with antibiotics during pregnancy may reduce the risk of passing the bacterium from mother to child. People with medical conditions such as sickle cell disease * that put them at greater risk of developing serious bacterial infections are prescribed antibiotics to decrease the chance that sepsis can develop.

See also Bacterial Infections • Infection • Pneumonia • Skin and Soft Tissue Infections • Staphylococcal Infections • Streptococcal Infections • Urinary Tract Infections

Resources

Books and Articles

Black, Gary. Gyroscope: A Survival of Sepsis. Conshohocken, PA: Infinity, 2014.

McClelland, Heather. “Early Identification and Treatment of Sepsis.” Nursing Times 110, no. 4 (January 22, 2014). Available at: http://www.nursingtimes.net/clinical-subjects/infection-control/early-identification-and-treatment-of-sepsis/5067163.fullarticle (accessed July 7, 2016).

Websites

Centers for Disease Control and Prevention. “Sepsis Questions and Answers.” http://www.cdc.gov/sepsis/basic/qa.html (accessed July 7, 2016).

MedlinePlus. “Sepsis.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/sepsis.html (accessed July 7, 2016).

Organizations

Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 888-674-6854. Website: http://www.cdc.gov (accessed July 7, 2016).

Sepsis Alliance. 501 West Broadway, Suite 1660, San Diego, CA 92101. Telephone: 619-232-0300. Website: http://www.sepsis.org (accessed July 7, 2016).

* systemic (sis-TEM-ik) is a problem affecting the whole system or whole body, as opposed to a localized problem that affects only one place on the body.

* toxins are substances that cause harm to the body.

* immune system (im-YOON SIStem) the system of the body that includes specialized cells and the substances they produce that helps protect the body against disease-causing germs.

* pneumonia (nu-MO-nyah) is inflammation of the lungs.

* urinary tract (YOOR-ih-nair-e) is the system of organs and channels that makes urine and removes it from the body. It consists of the urethra, bladder, ureters, and kidneys.

* intestines are the muscular tubes that food passes through during digestion after it exits the stomach.

* gallbladder is a small pearshaped organ on the right side of the abdomen that stores bile, a liquid that helps the body digest fat.

* intravenous, (in-tra-VEE-nus), or IV, means within or through a vein. For example, medications, fluid, or other substances can be given through a needle or soft tube inserted through the skin's surface directly into a vein.

* bedsores, also called pressure sores, are skin sores caused by prolonged pressure on the skin and typically are seen in people who are confined by illness or paralysis to beds or wheelchairs.

* delirium (dih-LEER-e-um) is a condition in which a person is confused, is unable to think clearly, and has a reduced level of consciousness.

* shock is a serious condition in which blood pressure is very low and not enough blood flows to the body's organs and tissues. Untreated shock may result in death.

* clotting is the body's way of thickening blood to stop bleeding.

* platelets (PLATE-lets) are tiny disk-shaped particles within the blood that play an important role in clotting.

* dialysis (dye-AL-uh-sis) is a process that removes waste, toxins (poisons), and extra fluid from the blood. Usually dialysis is done when a person's kidneys are unable to perform these functions normally.

* respiratory failure is a condition in which breathing and oxygen delivery to the body are dangerously altered. This failure may result from infection, nerve or muscle damage, poisoning, or other causes.

* septic shock is a condition due to overwhelming infection and is characterized by decreased blood pressure, internal bleeding, heart failure, and, in some cases, death.

* catheters (KAH-thuh-ters) are small plastic tubes placed through a body opening into an organ (such as the bladder) or through the skin directly into a blood vessel. They are used to give fluids to or drain fluids from a person.

* vaccination (vak-sih-NAY-shun), also called immunization, is giving, usually by an injection, a preparation of killed or weakened germs, or a part of a germ or product it produces, to prevent or lessen the severity of the disease caused by that germ.

* vagina (vah-JY-nah) is the canal, or passageway, in a woman that leads from the uterus to the outside of the body.

* sickle cell disease is a hereditary condition in which the red blood cells, which are usually round, take on an abnormal crescent shape and have a decreased ability to carry oxygen throughout the body.

  This information is not a tool for self-diagnosis or a substitute for professional care.