What is sepsis?
Sepsis is a life-threatening condition in which the body’s unregulated response to an infection impairs blood flow and damages organs.
Important sepsis facts include:
Sepsis is not an infection. It is an out-of-control immune response to an infection already present in the body.
Sepsis progresses quickly. Within minutes of encountering substances from an infection, the immune system triggers a chain of events throughout the body that can rapidly lead to sepsis. While the infection can remain localized, sepsis is systemic, meaning it affects the entire body.
Sepsis is more likely to occur in people with a chronic health condition.
Infection anywhere in the body can trigger sepsis. However, common sites of infection that lead to sepsis include the lungs, kidneys and skin.
The risk of dying from sepsis is 10 to 30%, but the condition is treatable with early diagnosis and medical intervention.
Sepsis can be prevented by reducing the risk of infection, knowing the signs of infection, and promptly treating infections.
What are the signs and symptoms of sepsis?
The signs and symptoms of sepsis include:
Change in mental status, such as confusion or a feeling of disorientation
High heart rate higher than 90 beats per minute (normal, adult heart rate is 60 to 100 beats per minute)
Rapid breathing with 22 or more breaths per minute (normal adult rate is 12 to 20 breaths per minute)
Sweaty, clammy, slick or sticky skin
Who gets sepsis?
Sepsis can develop in anyone with an infection. However, it tends to strike people who have a medical or health condition that puts them at higher risk of sepsis compared to healthy people. In the United States, approximately 1.7 million people a year develop sepsis. Most people who develop sepsis are already in the hospital receiving treatment for another condition.
Populations with sepsis risk factors include:
People who are 65 years and older, younger than one year, or pregnant
People who have a weakened immune system, which increases the risk of serious infections
People who have medical devices inserted in the body, such as breathing tubes or urinary catheters
What are some conditions related to sepsis?
Conditions related to sepsis include:
Bloodstream infection—commonly known as blood poisoning, a condition in which bacteria are multiplying and spreading in the blood. Some people use the term ‘septicemia’ to describe a bloodstream infection. Although a bloodstream infection can trigger sepsis, the conditions are distinct. Sepsis experts are leading efforts in the medical and mainstream communities to discourage use of the term ‘septicemia.’
Septic shock—a severe form of sepsis marked by very low blood pressure, seriously low level of oxygen in the blood, multiple organ failure, and a higher risk of mortality than sepsis
Systemic inflammatory response syndrome (SIRS)—a condition like sepsis, but which can occur in the absence of infection or organ failure
Toxic shock syndrome—a type of septic shock caused by the release of bacterial toxins into the bloodstream
What are the long-term effects of surviving sepsis?
Around 1.4 million people a year survive sepsis in the United States. Many survivors have lifelong problems, with nearly 60% reporting negative mental or physical effects. Physical and mental rehabilitation, both in the hospital and after discharge, can help people recover.
Complications of sepsis include:
Increased risk of infection from a damaged immune system
Limb amputation from removing infected or dead tissue
Neurological complications including problems with cognition, vision, communication, and memory
Organ damage including kidney, heart and lung damage
Post-traumatic stress disorder
Can you die from sepsis?
Sepsis is one of the most fatal conditions in hospitals. An estimated 1 in 3 people who die in the hospital have a sepsis diagnosis. Overall, about 250,000 people die from sepsis each year. Elderly people and very young infants, as well as patients with chronic medical conditions have a poorer sepsis prognosis. These groups are most at risk of septic shock and dying from sepsis.
What causes sepsis?
The cause of sepsis is an abnormal and heightened immune response to infection. Common microbes causing sepsis include the bacteria Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Group A and B Streptococcus, which includes the germ that causes strep throat. Certain viral and fungal infections can cause sepsis too, but this is much less common.
With sepsis, the immune system makes both pro- and anti-inflammatory substances. It is the interplay between these substances and other factors that determines sepsis severity. Some of these immune system factors cause an increase in blood clotting and some lead to a decrease in blood pressure. Both situations reduce blood flow to vital organs, which impairs organ function.
Why some people and not others get sepsis is not fully known. Factors that influence the development of sepsis and its outcome include:
Coexisting medical conditions—people with a weakened immune system from either an illness or medications have a greater risk of developing sepsis.
- Genetics—certain genes appear to be linked to sepsis, septic shock, and sepsis survival
Infection site—lung, urinary tract, skin, and intestinal infections are the most common infections leading to sepsis.
Virulence of the pathogen—the toxicity and degree of tissue damage caused by the microbe influences sepsis severity.
How is sepsis diagnosed?
Sepsis is diagnosed based on the presence of an infection (suspected or confirmed) and signs of organ damage or failure. A doctor who suspects sepsis reviews the patient’s symptoms, vital signs, and test results including:
Bacterial cultures and other tests to check for infection. These tests require samples of urine, chest sputum, blood, or samples of secretions from a wound or incision.
Blood tests to check for abnormal blood cell counts, increased blood clotting, and organ damage or failure
In 2016, a sepsis task force developed a set of criteria for medical professionals to identify septic patients, the Sequential Organ Failure Assessment (SOFA). The criteria are complex, so the task force simplified it to quick SOFA (qSOFA).
A qSOFA of at least two points indicates organ failure and signals the need for additional testing. Each of the following is one point:
Change in mental status
Respiratory rate of more than 22 breaths per minute
Systolic blood pressure less than or equal to 100 mmHg (this is the higher number of a blood pressure reading)
What are common treatments for sepsis?
Emergency and critical care medical teams act fast to treat sepsis. The goals are to clear the infection and provide intensive care to stabilize the patient and prevent septic shock. Sepsis treatment occurs in a hospital’s intensive care unit (ICU).
IV (intravenous) antibiotics and antimicrobials to treat the cause of the infection
IV fluids to increase blood volume and boost blood pressure
Vasopressor medication to increase blood pressure if IV fluids are not enough
Supplemental oxygen to help with breathing. A breathing tube and mechanical ventilation may be necessary in severe cases.
Surgery and other procedures to remove the infection, such as draining an abscess or skin surgery to remove dead tissue
Other treatments that may be necessary include corticosteroids, blood transfusions, sedation, pain control, and dialysis. When the prognosis is poor, palliative care and end-of-life care planning may be options.
Additional sepsis facts
Many healthcare organizations from the local to national level have taken steps to reduce sepsis and sepsis deaths. Hospitals with programs for sepsis, including sepsis screening for very ill, high-risk patients, see fewer patients dying from sepsis.
September is Sepsis Awareness Month. Learn more about sepsis and the Get Ahead of Sepsis campaign.