What is Sepsis? Symptoms and Diagnosis

Sepsis 101

Did you know? One out of every three patients who dies in a hospital has sepsis. In fact, at least 1.7 million adults in the US develop sepsis every year, and nearly 270,000 die as a result.¹ Despite these startling numbers, many are unfamiliar with sepsis and its risks.

Elderly man in blue hospital gown in a hospital bed holds hands with and looks at woman visitor

What is Sepsis?

Sepsis is the result of a body's extreme response to an infection. Sometimes, chemicals released by the immune system in the bloodstream to fight an infection can trigger a chain reaction of inflammation throughout the body. This is sepsis, and it can escalate to tissue damage, organ failure, and even death.

Just about any infection can lead to sepsis, but some infections are more likely to cause sepsis than others. These include respiratory, urinary, gastrointestinal, and skin infections. In the respiratory tract, influenza and SARS-CoV-2 are common viral causes of sepsis.

Everyone with an infection can develop sepsis, but those most at risk include children, the elderly, those with compromised immune systems, and those with some chronic conditions.

Cost of Sepsis

Sepsis exacts a large toll in terms of people impacted, lives lost, and costs to the healthcare system. Sepsis is the number one killer of children in the US, outpacing pediatric cancers. Globally, 3.4 million children die with sepsis each year, including 6,800 children in the US from severe sepsis. More US adults die from sepsis annually than from prostate cancer, breast cancer, and opioid overdoses combined.²

Even patients who survive sepsis can have long-lasting and life-altering health impacts. In fact, as many as 50% of sepsis patients end up with long-term physical and/or psychological impacts.² For example, amputation is sometimes required as a result of sepsis, as the condition may restrict adequate blood flow to extremities causing the affected tissue to die. The US saw 13,700 sepsis-related amputations in 2012.²

Sepsis also ratchets up overall healthcare costs—it doubles the average cost of a hospital stay, compared with the average cost for all other conditions.2 In total, the costs for acute sepsis hospitalization and skilled nursing are estimated at $62 billion in the US each year.²

Diagnostics and Treatment of Sepsis

Recognizing sepsis can be difficult, especially in its early stages. Common signs and symptoms include a rapid heart rate, low blood pressure, shortness of breath, fever, pain, and confusion. The effort to diagnose sepsis involves close monitoring of the underlying infection, observation of clinical symptoms, and, ideally, timely laboratory results.

Treating sepsis requires a multipronged approach that includes intravenous fluids, vasopressors to help stabilize blood pressure when necessary, and therapy to address the underlying infection—this often means broad-spectrum antibiotics or, sometimes, antifungals. Other medications may be needed to maintain blood sugar levels and address fever, pain, and discomfort.

Sepsis and the Problem of Antimicrobial Resistance

Time is of the essence when it comes to sepsis. Early identification of sepsis and quick initiation of antimicrobial therapy is strongly correlated with improved outcomes for patients. That urgent need to begin therapy can prompt providers to administer broad-spectrum antimicrobials well before they receive the laboratory results that would enable more targeted treatment.

Unfortunately, this reflexive use of broad-spectrum antimicrobials can deepen the increasingly serious problem of antimicrobial resistance. It's a circular problem: the broad-spectrum antimicrobials used to treat sepsis can lead to greater antimicrobial resistance. And pathogens that have become resistant can lead to sepsis when an infection cannot be controlled.

One key to disrupting this pattern is rapid identification of the probable causative pathogen, which enables targeted, rather than empiric broad-spectrum, therapy.

Icon of white and red lab results on a white background.

The Syndromic Approach

Traditional testing can be slow and insensitive, particularly when clinicians must rule out suspected pathogens one at a time. That's why syndromic testing from BIOFIRE targets a broad menu of possible pathogens with one quick multiplex PCR test. The BIOFIRE^® Blood Culture Identification 2 (BCID2) Panel identifies 33 possible pathogens—including gram-positive bacteria, gram-negative bacteria, and yeast—along with 10 antimicrobial resistance genes, with results in about an hour from a positive blood culture.

The first-generation BIOFIRE^® FILMARRAY^® Blood Culture Identification (BCID) Panel has been shown to dramatically reduce the time from blood culture collection to organism identification, compared to traditional testing. The average time to organism identification before adoption of the BIOFIRE BCID Panel was 57.4 hours. After adoption, the time fell to 17.2 hours—a 70% reduction in time to organism identification.³

Fast results enable clinicians to quickly start patients on appropriate, targeted therapy. Combined with antimicrobial stewardship interventions, the BIOFIRE BCID Panel decreased time to optimal therapy by 33.5 hours.⁴ This is beneficial for sepsis patients, who receive fast, targeted therapy, and for the larger fight against antimicrobial resistance.