DEAR MAYO CLINIC: I continue to read about people who get extremely sick or even die while in the hospital because of sepsis. What causes it? Isn't there a way to prevent it?
ANSWER: Sepsis is a serious, potentially life-threatening complication related to an infection. Although sepsis is hard to prevent, if it is identified and treated quickly with fluids and antibiotics, the chances for a full recovery are good.
If left unchecked, sepsis can progress to a condition known as severe sepsis. Severe sepsis makes it hard for blood to flow to the vital organs. As a result, the heart, lungs, brain and kidneys can all be damaged. Progression of severe sepsis can result in septic shock, a life-threatening situation in which organs begin to fail and blood pressure drops dramatically.
Good hygiene, including hand washing, getting vaccines at the recommended time, and avoiding sources of infection can reduce the risk for sepsis. Any kind of infection can trigger sepsis. However, certain infections -- such as pneumonia, abdominal or kidney infection, and infections that affect the blood -- have a higher likelihood of causing sepsis.
The number of sepsis cases is increasing and although the reason for the increase is not entirely clear, it seems to be connected to several factors.
First, age is a significant risk factor for sepsis. Today, more people are living longer than ever before, resulting in a rise in sepsis. The elderly and the very young are at higher risk because their immune systems are not as effective at fighting infection.
Second, people with weak immune systems are more vulnerable to sepsis. Many people have weakened immune systems due to medical conditions, such as diabetes or HIV/AIDS. Additionally, medical treatments, including medications taken after an organ transplant and certain cancer treatments can weaken the immune system. A severe illness that requires hospitalization, can also weaken a person's immune system and raise the risk of sepsis. Similarly, a damaged protective skin barrier resulting from previous wounds or burns increases the risk for infections.
Third, in recent years the number of drug-resistant bacteria has increased. These bacteria are often the root cause of the infections that trigger sepsis. Drug-resistant bacteria can occur in people who have been on antibiotics in the past or who are already very sick and in the hospital.
Fourth, medical devices such as intravenous catheters or breathing tubes are used more now than in the past. These devices raise a person's risk for infections.
If someone known or suspected to have an infection begins to experience sepsis symptoms, it's critical that they get medical care right away. Hospital staff members watch patients closely for sepsis, particularly those in the emergency room and in intensive care units. If sepsis is recognized, immediate action is taken. Patients receive plenty of fluids and appropriate antibiotics are immediately administered.
If they are not already in the hospital, people diagnosed with sepsis normally require hospitalization. In addition to antibiotics, other medication may be used to treat symptoms such as low blood pressure. People with severe sepsis may need help breathing and often require oxygen.
The longer sepsis is allowed to progress, the higher the chances it will become life-threatening. Research has shown that if treatment is started within six hours from the time sepsis begins, the mortality rate falls dramatically. That makes early, aggressive treatment of sepsis critical. If it is identified quickly, sepsis can often be effectively managed. -- Kannan Ramar, MBBS, M.D., Pulmonology and Critical Care Medicine, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. E-mail a question to firstname.lastname@example.org. For more information, visit http://www.mayoclinic.org.)