World Sepsis Day | Doctor explains why it's life-threatening condition & who is at risk

Sepsis, a life-threatening condition caused by an overactive immune response to an infection can lead to organ damage, shock, and even death especially if not recognised early and treated promptly. Despite advancements in healthcare, sepsis remains a severe threat with high mortality rates, especially in vulnerable populations such as the elderly, those with compromised immune systems, and pregnant women.

According to the WHO, nearly half of all sepsis cases occur in children under 5 years of age. Dr. Sandeep Dewan, Senior Director and Head of Critical Care at Fortis Memorial Research Institute (Gurugram) discusses the challenges associated with sepsis.

Can you explain what sepsis is and why it remains a significant global health challenge?

Dr. Dewan: Sepsis is a syndrome where an infection happens in a certain part of a body and it spreads through the blood causing organ dysfunction. Sepsis has various forms the early part of sepsis is called SIRS where it’s only inflammation and the late part of sepsis is called septic shock, because of the spread of infection in the blood the blood pressure of the patient starts to fall.

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Why is early detection critical in reducing sepsis-related mortality, and what signs should healthcare professionals look for?

Dr. Dewan: Sepsis continues to have a high mortality rate, with 40-50% of patients succumbing to the condition despite advances in healthcare. Timely detection is crucial, as even an hour’s delay in prescribing antibiotics can increase mortality by 4-5%. Early signs of sepsis are fever breathing difficulty sometimes nausea. Patients may also experience drowsiness due to a drop in blood pressure. When healthcare professionals observe these early indicators, they should immediately suspect sepsis and admit such patients for treatment.

How does the progression of sepsis differ from patient to patient, and what are the risk factors?

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Dr. Dewan: Sepsis is different from patient to patient, as it also depends upon the immunity of the patients. Patients who are elderly or have pre-existing conditions like heart failure, asthma, or cancer, or those undergoing steroid treatment, often have weakened immunity. In such cases, even minor infections can escalate into life-threatening situations, potentially leading to death. This makes it essential for individuals, particularly those over 65 years of age, to be vigilant and not ignore the initial symptoms of sepsis.

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Why are pregnant women at a higher risk of developing sepsis, and what preventive measures can be taken?

Dr. Dewan: Pregnancy is a xx hold, pregnancy also comes under the category of immunocompromise state so, pregnant females become at higher risk of developing sepsis. Preventive measures can be the same as early detection and early recognition of features and if in doubt then can be shown to a physician as early as possible.

What are the most common infections that lead to sepsis during pregnancy, and how can they be effectively managed?

Dr. Dewan: The most common infections during pregnancy are urinary tract infections, pneumonia and obviously these can be effectively managed by early detection and by showing to physician and as early as antibiotics can be started.

How can healthcare providers better protect both mother and child from the risk of sepsis during pregnancy and childbirth?

Dr. Dewan: Common causes of sepsis in postoperative patients are basic diseases because sometimes if a patient comes with a disease that itself causes the infection. Even if you operate the patient, the postoperative effects of sepsis can be felt.

What are the common causes of sepsis in post-operative patients, and what steps can be taken to reduce the risk?

Dr. Dewan: High-risk patients are prone to sepsis and sepsis-related deaths because their basic immunity is low. So, any surgical procedure gives stress to the body. This stress along with the immunocompromised state of the patient, increases the chances of sepsis development in postoperative patients.

How do surgical procedures, especially in high-risk patients, increase the likelihood of sepsis development?

Dr. Dewan: A range of blood tests are available for diagnosing sepsis, ranging from conventional to cutting-edge approaches. While a Complete Blood Count (CBC) has traditionally been used as a diagnostic aid, specific markers like C-reactive protein (CRP) and Serum procalcitonin offer valuable additional information about the body’s inflammatory response. In recent times, advanced diagnostic techniques have emerged, including the PCR-RNA (Polymerase Chain Reaction-RNA) method and innovative tools like BioFire, which enable faster and more precise identification of pathogens and improve the speed and precision of diagnosis.

What tools and technologies are currently available for the early detection of sepsis?

Dr. Dewan: In resource-limited areas, telemedicine can play a crucial role in addressing the shortage of qualified specialists. The main challenge in these regions is the lack of access to specialized care, which is critical for timely sepsis treatment. By connecting patients in rural areas with experienced doctors from larger hospitals through telemedicine, specialized doctors can remotely guide junior physicians or healthcare workers in diagnosing and managing sepsis.