Is sepsis so dangerous?

Sepsis is the body's response to developing infection. It is currently defined as a syndrome of systemic inflammatory response caused by infection. Currently, the presence of microorganisms in the blood is not necessary for diagnosing sepsis, although in most cases, microorganisms spread from the source of infection through the bloodstream. The most common causes of sepsis are pneumonia and urinary tract infections, but any other infection can trigger it in predisposed individuals. From a bacteriological point of view, any microorganism can cause sepsis, although parasites, viruses, and atypical bacteria are relatively rare.

The type of microorganism causing the infection is often associated with the risk factor and the site of infection initiation. For example, Staphylococcus aureus from blood infections originates from purulent lesions on the skin and soft tissues, pneumonia, and catheters placed in blood vessels. Blood infections with enterococci come from urinary, gastrointestinal, and abdominal infections, while pneumococcal sepsis mainly originates from pneumonia. Meningococcal meningitis in children often accompanies systemic infection with the same cause. Abdominal infections, pneumonia, and urinary tract infections are most often the starting point for general infections.

Practically all known bacteria can cause septicemia. Often, the starting point may be the so-called primary focus of infection. It may be, for example, gallbladder infection, urinary tract infection, skin abscess, or newborn umbilical cord inflammation, from which bacteria in the blood are transferred to distant organs or tissues of the human body, thus spreading the inflammatory process. The bacterium most commonly associated with fulminant forms of severe sepsis is Neisseria meningitidis. Sepsis accompanied by failure of at least two organs or systems (MOF, MODS) is called severe sepsis. When circulatory failure develops that does not respond to standard treatment, it is called septic shock.

It is currently believed that the primary factor initiating sepsis is bacterial endotoxin. It is released when a bacterial cell is destroyed, either by natural immune mechanisms or chemotherapy. The released endotoxin is bound in the blood plasma by specific binding protein, forming a stable complex. These complexes are recognized by immune cells via a specific membrane receptor. Binding of the complex by the receptor triggers a reaction in the form of cytokine release. These cytokines, or rather the organs' and tissues' reaction to them, are responsible for the clinical picture of sepsis. As a severe inflammatory reaction, sepsis causes damage and dysfunction of the body's cells, which can secondarily lead to multiple organ failure. However, regardless of the initiating factor, the development of sepsis symptoms depends on the action of pro-inflammatory cytokines.

The clinical picture of sepsis depends on the stage of the entire process. In the initial period, there are symptoms of systemic inflammatory response (acceleration of heart rate, accelerated breathing, body temperature above or below the norm, leukocyte count above or below the norm). Additionally, symptoms of a specific infection may be present, e.g., pneumonia. In the absence or inadequate treatment, symptoms of organ and system failure appear.

In the development of these disorders, a mechanism of a vicious circle operates, consisting of intensifying the dysfunction of one system by the dysfunction of the other, which is itself subjected to the adverse effects of the first one (positive feedback). In reality, this is a multi-system mechanism, and the changes that occur are connected by a complicated network of relationships. The result is usually multiple organ failure syndrome, often leading to fatal consequences. The basis and necessary condition for conducting effective sepsis treatment is the elimination of the source of infection. All other disorders are treated symptomatically.

Sepsis infection is a global health problem, and although precise epidemiological data may vary by region and source, sepsis is a common problem. It is estimated that there are many cases of sepsis worldwide every year.

According to organizations such as the World Health Organization (WHO) and the Global Sepsis Alliance (GSA), sepsis is one of the leading causes of death worldwide. It is estimated that sepsis affects millions of people and leads to hundreds of thousands of deaths each year.

One of the problems in determining the exact number of sepsis cases is that the definition of sepsis and its diagnostic criteria may vary depending on the organization and country. Additionally, not all sepsis patients are hospitalized, and some cases may remain unrecognized or improperly diagnosed.

It is important to understand that sepsis is a serious condition and can occur in people of different ages and health conditions. As diagnostic and awareness improvements regarding sepsis continue, the number of cases recognized and treated may increase. However, sepsis remains a challenge in global healthcare and requires further research and action to improve its recognition and treatment.