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Health Matters 9/10: September is Sepsis Awareness Month

By David J. Herman, MD

The Sepsis Alliance has designated September as Sepsis Awareness Month to bring awareness to sepsis, the body’s life-threatening response to infection.

Sepsis affects 1.7 million people and claims approximately 270,000 lives every year in the United States, according to the Sepsis Alliance.

In fact, sepsis takes more lives than opioids, breast cancer and prostate cancer combined.

Knowing the signs of sepsis and seeking emergency care can help prevent serious complications and save lives.

What is sepsis?

Sepsis is a severe inflammatory response to infection that can lead to tissue damage, organ failure and death.

When your body is working as it should, your immune system serves to prevent infections caused by invaders like bacteria, viruses, parasites and fungus. If the invaders get through and infection does occur, your immune system will work to fight it.

Sepsis occurs when your immune system goes into overdrive and begins attacking healthy tissues throughout your body rather than targeting the infection.

Septic shock occurs when multiple organs dysfunction and your blood pressure drops. As more organs fail, the risk of death increases. At this stage, sepsis is incredibly difficult to treat.

What causes sepsis?

Bacterial infections are the most common cause of sepsis, but sepsis can also be a result of other infections, including viral infections, such as influenza or COVID-19.

According to the Centers for Disease Control and Prevention, infections that lead to sepsis most often start in the lung, urinary tract, skin or gastrointestinal tract.

Recent research reports that hospitalized COVID-19 patients are 22% more likely to develop serious sepsis than hospitalized influenza patients and four times more likely to develop severe septic shock, according to the Sepsis Alliance.

What are the symptoms?

Symptoms of sepsis can include:

• Fever, shivering or feeling very cold
• Clammy or sweaty skin
• High heart rate or low blood pressure
• Confusion or disorientation
• Extreme pain or discomfort

If you have an infection that is not getting better or getting worse and you are experiencing signs of sepsis, seek immediate medical attention. Sepsis is a medical emergency. Fast diagnosis and prompt treatment can reduce the risk of severe complications and death.

Who is at risk?

Anyone who has an uncontrolled infection is at risk for sepsis. However, older adults and young children are at greater risk than others.

Additionally, people with weakened immune systems or chronic medical conditions, such as diabetes, lung disease, cancer and kidney disease, are at risk for sepsis, as are people with recent severe illness or hospitalization.

Does being in the hospital increase the risk for sepsis?

Being hospitalized can increase your risk for a hospital-acquired infection, which in turn can increase your risk for sepsis.

However, the vast majority—as many as 87 percent—of sepsis cases originate outside of a hospital setting, according to the Sepsis Alliance.

At Penn Medicine Princeton Health, care providers follow strict health and safety protocols to help protect patients from hospital-acquired infections.

For example:

• Alcohol-based hand sanitizer is available for medical staff and visitors at convenient locations in all patient-care areas and throughout the hospital. Staff members perform hand hygiene before and after each patient encounter.

• In addition to wearing masks as the COVID-19 pandemic continues, hospital staff may don other protective equipment as needed. For patients who have conditions that may require additional precautions, a sign is posted at the doorway of the patient room to alert staff and visitors.

• All healthcare personnel are required to be vaccinated against COVID-19 and influenza.

• Staff follows best practices to prevent infection related to central venous lines, urinary catheters, ventilator use, and surgery.

Moreover, additional measures are in place for the early detection and treatment of sepsis in hospitalized patients.

What are the complications of sepsis?

While many people make a full recovery from sepsis, it can result in serious complications, including:

• Amputations
• Kidney failure
• Permanent lung damage
• Permanent brain damage
• Damage to your heart valves, which can lead to heart disease

How is sepsis treated?

Time is of the essence when it comes to treating sepsis. For every hour treatment is delayed, the risk of death increases by as much as 8%, according to the Sepsis Alliance. The Alliance also notes that as many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment.

Treatment for sepsis typically involves a combination of antibiotics to treat the infection and IV fluids to prevent blood pressure from dropping and to keep organs functioning. Antibiotics are normally delivered intravenously so they can get into the bloodstream and start working quickly.

Other medications and techniques may also be used depending on the severity of sepsis and the patient’s condition.

How can sepsis be prevented?

The best way to prevent sepsis is to prevent infection, and if infection does occur, to treat it as quickly as possible.

Steps you can take to prevent infection include:

• Getting vaccinated. Not all infections can be prevented with vaccines, but common infections such as influenza, pneumonia, shingles, as well as COVID-19, can be prevented with vaccination. Although vaccines are not 100% effective in preventing infection, most people who are vaccinated develop less serious manifestations of infection than what is seen in unvaccinated people.

• Caring for wounds. Any scrape, cut, or break in the skin can allow bacteria to enter and cause an infection. Always wash your hands before touching an open wound. Clean the wound with water, apply an antibiotic cream or ointment if desired, and cover the wound with a bandage to keep germs from entering. If the wound is deep, it may require stitches.

• Washing your hands. Washing your hands regularly can help prevent infection and keep you healthy. To wash your hands properly, use clean, running water and soap. Lather and scrub for at least 20 seconds, rinse and dry. If you do not have access to soap and water, you can use an alcohol-based hand sanitizer with at least 60% alcohol.

Remember, if you have an infection, be sure to treat it right away, and if you develop signs of sepsis, seek immediate medical care. The quicker sepsis is diagnosed and treated, the greater the chances of making a full recovery.

To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.

David J. Herman, MD, is board certified in infectious disease and internal medicine. He is the chairman of the Infectious Diseases Committee at Penn Medicine Princeton Health.

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