Proper infection control practices by healthcare providers are critical to reduce the risk of sepsis.
Any type of infection can lead to sepsis, a life-threating emergency related to the body’s extreme response to infection, according to the Centers for Disease Control (CDC). Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.
Each year, at least 1.7 million adults in America develop sepsis, according to the CDC. Bacterial infections cause most cases of sepsis; however, sepsis can also be the result of viral infections such as COVID-19 or influenza.
“Any infection, from the tiniest source (a bug bite, a hangnail, etc.) to the more severe (pneumonia, meningitis, and more), can trigger sepsis, which can lead to severe sepsis and septic shock,” said Thomas Heymann, Sepsis Alliance President and CEO. “The infection can be bacterial, viral, fungal, or parasitic.”
Infants and the elderly have the highest risk of developing sepsis, as well as patients that are immunocompromised or have a chronic illness. Most cases of sepsis begin before a patient goes to the hospital, according to the CDC, and at least 350,000 adults in the U.S. who develop sepsis die during hospitalization or are discharged to hospice.
Recognizing sepsis
Sepsis Alliance works across the nation to save lives and reduce suffering from sepsis by providing healthcare professionals, lawmakers, and the public with education and support on sepsis.
Recognizing the warning signs of sepsis can get patients to much-needed emergency care faster, according to Sepsis Alliance. Symptoms of sepsis, according to the CDC, include clammy or sweaty skin, confusion or disorientation, extreme pain or discomfort, fever, high heart rate or weak pulse, and shortness of breath.
“Sepsis Alliance uses the acronym ‘It’s About TIME™’ when referring to the symptoms of sepsis, which include T- Temperature higher than normal, I- infection, M- mental status decline, and E- extremely ill, shortness of breath,” said Heymann. “Sepsis is a medical emergency. It should be treated as quickly and efficiently as possible as soon as it has been identified.”
Effective sepsis treatment in a healthcare setting includes the use of antibiotics, IV fluids, maintaining blood flow to organs, and other medications, according to Sepsis Alliance. Healthcare professionals will monitor a patient closely following a hospital admission for sepsis, carefully tracking vital signs and reassessing patient status.
Sepsis is an inflammatory response to infection, while septic shock is the most severe and life-threatening complication of sepsis. Patients with septic shock have very low blood pressure that cannot be easily corrected, often leading to multiple organ failure.
A significant number of people that receive sepsis treatment may still die in spite of it. “If sepsis is discovered and treated before it becomes septic shock, the mortality rate ranges from roughly 10% to 15%, nationwide, with striking exceptions on either side of that range,” said Dr. Steven Simpson, the Board Chair of Sepsis Alliance. “Some hospitals have driven mortality below 5%, and some remain above 20%. Septic shock is similar. Overall septic shock mortality remains roughly 40%, nationwide, while truly excellent hospitals have their mortality rates down to the upper teens.”
Hospital lengths of stay for sepsis vary on how ill a patient is when treatment begins. For those who do survive a sepsis hospitalization, said Dr. Simpson, about “75% will be left with chronic physical, psychological, or cognitive impairment.”
“Treatment for sepsis includes rapid administration of antibiotics and fluids,” said Heymann. “The risk of death from sepsis increases by an average of up to 7.6% with every hour that passes before treatment begins, which is why it’s so important for the public and healthcare professionals to recognize its symptoms.”
Sepsis Prevention
There are steps that can be taken to prevent infections leading to sepsis, including infection prevention awareness, practicing good hygiene, and understanding the signs and symptoms of sepsis.
Prevention of infections includes addressing chronic conditions and getting recommended vaccinations to reduce the severity of certain infections; keeping hands clean and wounds covered; and knowing the signs and symptoms of sepsis, according to the CDC.
“Sepsis Alliance stands behind the principle that ‘Infection prevention is sepsis prevention™!’,” said Heymann. “The only way to prevent sepsis is by preventing infections in the first place. That can be through vaccinations, good hygiene, proper care and treatment of wounds, hand washing, and antimicrobials as needed.”
“Most hospitals have plans in place to prevent hospital acquired infections to the extent that they can – to prevent sepsis,” said Dr. Simpson. “The best hospitals participate in continuous quality improvement to prevent infection in the patients they treat, and many of them participate in the CDC’s Nation Health Safety Network, reporting their rates of nosocomial (hospital acquired) infection and implementing strategies to drive them down.”
The future of sepsis prevention
The Centers for Medicare and Medicaid Services (CMS) designs Hospital Quality Initiatives (HQI) to assure delivery of quality health care for institutions. CMS defines sepsis for adults 18 years and older as having a source of infection plus two or more systemic inflammatory response syndrome criteria (SIRS), (based on temperature, respiratory rate, white blood cell count, etc.). Infection control for admitted sepsis patients is crucially important to their recovery.
“CMS considers certain infections to be 100% preventable and provides financial incentives on both the positive side (no infections) and the negative side (too many infections) to encourage hospitals to drive down infection rates,” said Dr. Simpson. “Such conditions include post-surgery, catheter-associated central line infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and Clostridium difficile infections.”
Infection control within healthcare settings includes proper physician education, disease tracking, multi-professional expertise, and more. According to the CDC, the development of a multi-disciplinary hospital sepsis program is critical to improving outcomes for sepsis patients.
“What we do as healthcare providers is to be vigilant, know that infections can occur, and intervene appropriately when they do – before the infection has a chance to evolve into the organ dysfunction that defines sepsis,” said Dr. Simpson.
Sepsis Alliance believes in educating the public about the signs and symptoms of sepsis, so they know to seek emergency care quickly, as, according to Sepsis Alliance, mortality for sepsis increases by 4-9% for every hour that treatment is delayed.
The organization also educates healthcare professionals to better diagnose and treat sepsis and care for sepsis survivors; and works in government to pass legislation around sepsis, infection prevention, and antimicrobial resistance.
“Sepsis Alliance is striving toward a more sepsis-safe world,” said Heymann. “We will save lives and limbs with our awareness efforts. Sepsis is a complicated, multi-faceted condition, as is our plan of attack for creating a more sepsis-safe world.”