The first global report by the World Health Organization (WHO) on sepsis or septicemia, published in 2020, highlighted serious deficiencies in information regarding this medical complication. It causes the death of 11 million people each year, many of them children, and millions of cases of disability. So, what is sepsis?
The definition of septicemia, also known as sepsis, has been evolving in recent times. In the dictionary of the Royal National Academy of Medicine of Spain, it is described as:
In the Third International Consensus Definitions for Sepsis and Septic Shock (2016), the concepts applicable to sepsis and septic shock were redefined:
In other words, it is a systemic inflammatory response to an infectious process (caused by bacteria, viruses, fungi, or parasites), generally severe, experienced by the host organism. In response to an infection, the body produces an exaggerated immune response (the immune system ends up working too hard), preventing normal blood functions, eventually affecting tissues. If not treated promptly, it can lead to septic shock, multiorgan failure, and death.
On paper, any infection can trigger sepsis, whether it's appendicitis, pneumonia, or a urinary tract infection. It can start as a mild condition, but it's not uncommon for it to rapidly progress to septic shock.
Babies, elderly individuals, and chronically ill patients with weakened immune systems, in general, are the ones most likely to suffer from this disease. The progression from infection to sepsis will depend on various factors, from the infecting germ being resistant to treatments to a genetic predisposition to such complications.
Early detection of sepsis is crucial, as well as administering the appropriate medications in each case. It is not an easy task, as in the initial phase, the symptoms are not very specific, although almost all are related to poor blood flow:
The issue, as detailed by the Autonomous University of Madrid, is that "there are many different infections (meningitis, pneumonia...), many different pathogens (meningococcus, the flu, fungi...) and there are equally different manifestations depending on each person. This is due to genetic polymorphism, meaning genetically we are different: the same infection can have different manifestations."
When a patient hospitalized for any other illness experiences sepsis, doctors administer a general treatment since they do not yet know specifically which pathogen is causing the infection.
Various measures implemented globally within the "Surviving Sepsis Campaigns" have reduced mortality related to severe sepsis and septic shock to below 25% in multicenter studies, demonstrating greater efficiency in resource management. In recent years, Spain has implemented a Sepsis Code in an increasing number of hospitals, with experiences showing significant reductions in mortality based on general guidelines.
However, as warned by the WHO, survivors of septicemia are also not out of danger: "only half of them will fully recover, the rest will die within a year or will be affected by long-term disabilities."