Sepsis is a life-threatening condition caused by the body’s extreme response to an infection. It is a medical emergency that requires rapid treatment to prevent organ failure and death. Sepsis affects at least 1.7 million adults in America each year, and more than 250,000 Americans die from sepsis annually (CDC, 2020). Given these alarming statistics, preventing sepsis is a major public health priority. This article will provide an overview of sepsis and discuss the number one way to help prevent this dangerous syndrome.
What is Sepsis?
Sepsis occurs when the body’s response to an infection spirals out of control, triggering widespread inflammation and impaired blood flow. This can lead to organ damage and death. Sepsis often starts with a bacterial, viral, or fungal infection. Common sites of infection include the lungs, urinary tract, skin, and gut. When the immune system detects an infection, it releases chemicals into the blood to fight it off. However, in some people, this response becomes amplified and excessive. Floods of immune cells and inflammatory proteins course through the body, damaging its own tissues and organs. Blood clots form, slowing circulation and depriving organs of nutrients and oxygen. Blood pressure plummets, driving the patient toward shock. Organ systems start to fail as the cascade of immune responses and complications worsen. Sepsis can arise from infections starting anywhere in the body. However, the most common triggers are:
– Lung infections such as pneumonia (40% of cases)
– Infections in the digestive or urinary tracts (30% of cases)
– Widespread infection throughout the body or bloodstream (septicemia) (30% of cases)
Some people are at higher risk for developing sepsis when they get an infection. Those at increased risk include:
– Adults 65 years or older
– People with weakened immune systems or chronic illnesses like diabetes, cancer, kidney disease, and lung disease
– Patients who have experienced a recent infection or hospitalization
– Individuals with injuries, burns, or wounds
– Children younger than 1
– Pregnant women and those who have recently given birth
Recognizing the signs and symptoms of sepsis quickly is vital. Symptoms often begin mildly but then rapidly escalate. They may include:
– Fever above 101°F or low body temperature below 96.8°F
– Rapid heart rate and rapid breathing
– Altered mental status, such as confusion or disorientation
– Clammy or sweaty skin
– Extreme pain or discomfort
– Pale or discolored skin
How Does Sepsis Lead to Organ Failure and Death?
In sepsis, widespread inflammation and blood clotting block oxygen and nutrients from reaching vital organs. This causes organs to lose function and ultimately fail. Some of the most commonly affected organ systems include:
Lungs: Fluid builds up in the air sacs of the lungs, making breathing difficult. Pneumonia is a common source of sepsis and can directly damage lung tissue.
Kidneys: Toxins, drugs, and cellular waste products build up in the blood as the kidneys lose their filtering capacity. This can lead to kidney failure.
Liver: Impaired blood and nutrient flow leads to cell death in the liver. Bilirubin and liver enzymes leak into the bloodstream.
Brain: Fever, swelling, and inflammation of brain tissue (encephalopathy) leads to delirium, seizures, and loss of consciousness.
Heart: Cardiomyopathy reduces the heart’s ability to pump blood effectively. Irregular heart rhythms may develop.
Intestines: Cell death in the intestinal lining allows bacteria to leak into the bloodstream, worsening sepsis. Paralytic ileus or intestinal paralysis can occur.
As more organs fail, fatal complications ensue:
– Septic shock: Blood pressure plummets, cutting off perfusion to organs and tissues. The heart cannot compensate despite maximum stimulation. Death occurs from multi-organ failure.
– Disseminated intravascular coagulation (DIC): Widespread microscopic blood clots consume the body’s clotting factors. Uncontrolled bleeding occurs as a result.
– Respiratory distress: Fluid in the lungs prevents oxygenation. Mechanical ventilation may be required or fail.
Sepsis leads to over 175,000 deaths annually in the U.S. It is imperative to recognize it quickly and initiate treatment.
What Is the Number One Way to Prevent Sepsis?
The number one way to prevent sepsis is to prevent infections in the first place through rigorous infection control measures. Stopping infections from taking hold reduces the risk of sepsis developing. Infection prevention should be practiced in all healthcare settings as well as the community. Key strategies include:
Infection Control in Healthcare Settings
Healthcare providers must follow strict protocols to avoid passing infections between patients or introducing new pathogens from the outside environment. Measures include:
– Aggressive hand washing hygiene among staff using soap and water or alcohol-based hand sanitizer
– Use of personal protective equipment (PPE) like gowns, gloves, and masks
– Proper disinfection and sterilization of medical equipment and surfaces
– Isolation of patients with contagious illnesses
– Avoiding unnecessary medical procedures that breach the skin or mucous membranes
– Air filtration and surface disinfection to reduce environmental pathogens
– Safe injection practices and needle disposal
– Judicious use of antibiotics to avoid breeding resistant bacteria
– Screening patients, visitors, and staff for illnesses upon entry to healthcare facilities
– Tracking infections and analyzing outbreaks to identify problems and solutions quickly
Preventing Infections in Community Settings
Members of the public should also take steps to avoid infections through:
– Hand washing with soap and water before eating or touching the face
– Keeping up to date on immunizations like flu, pneumonia, shingles, and pertussis vaccines
– Covering coughs and sneezes to reduce spread of droplets
– Staying home when sick to avoid exposing others
– Proper food handling, cooking temperatures, and refrigeration
– Avoiding illicit drug use and unsafe injections
– Using protection and practicing safe sex to prevent sexually transmitted diseases
– Completing the full course of antibiotics as prescribed to eradicate the infection
Preventing Infections in High-Risk Groups
Special efforts must target populations at increased risk of infection and sepsis, including:
Infants and children
– Breastfeeding strengthens the immune system
– Childhood vaccination series
– Hand hygiene among children and caregivers
– Prompt care for fevers and suspected infections
Older adults
– Vaccination against pneumonia, influenza, shingles
– Treating urinary tract infections quickly
– Monitoring for recurring infections
– Preventing pressure injuries and wound infections
– Recognizing early signs of sepsis
People with chronic illnesses
– Tight blood glucose control in diabetes
– Preventing and monitoring infections in immunocompromised patients
– Preventing central line, wound, urinary tract, and respiratory infections
– Medication compliance and flu/pneumonia vaccines
Post-surgical patients
– Antibiotic prophylaxis prior to surgery
– Skin antisepsis prior to incision
– Preventing surgical site and central line infections
– Early recognition of post-op sepsis
Newborns
– Hand hygiene for caregivers
– Preventing Group B Strep transmission
– Monitoring for early-onset neonatal sepsis
– Avoiding premature birth and low birthweight
Rapid Identification and Treatment of Infections
While infection prevention is paramount, it is also critical to identify and treat any infections rapidly before sepsis can develop. This requires:
– Educating the public on sepsis signs and symptoms
– Accessible healthcare and prompt medical evaluation
– Obtaining cultures to identify the organism and its antibiotic susceptibility
– Initiating fast and appropriate antibiotic therapy and resuscitation
Conclusion
Sepsis is a life-threatening syndrome resulting from uncontrolled infection. It causes multi-organ failure and claims hundreds of thousands of lives each year. The number one way to prevent sepsis is through comprehensive infection control measures in healthcare and community settings. This includes hand hygiene, protective equipment, sterilization, isolation precautions, judicious antibiotic use, immunizations, and avoiding high-risk behaviors. Special efforts must also focus on preventing infections in vulnerable groups and rapidly identifying and treating any infections before they progress to sepsis. While treatment advances have improved sepsis outcomes, prevention remains the key to reducing its incidence and mortality impact through infection control.