« Always consider sepsis in the context of infection. »

According to the World Health Organization, there are around 49 million cases of sepsis worldwide every year, and 11 million sepsis-related deaths. Despite its high incidence and lethality, sepsis remains largely unknown to the general public. « Most infections are simple, and can be treated outside the hospital », explains Dr Rafael Moraes, director of ILAS, the Latin American Institute of Sepsis (Brazil). « But sometimes an infection triggers an extreme immune response that leads to organ dysfunction. »

A study conducted in the US showed that 87% of sepsis cases begin in the community . « Think UTIs, children with cuts that get infected, dental abscesses, things like that », comments Thomas Heymann. « Sepsis can evolve very quickly. It's important that the public understand when it might be more than an infection, and that they need to seek care. » This is a priority for all three associations.

In 12 years, The UK Sepsis Trust has managed to raise public awareness of sepsis in the country from 27% to 91%. This great success truly demonstrates how with coordinated efforts, we can increase public awareness regarding critical public health problems, thereby saving lives. But globally, the majority of the work is still to be done

A survey carried out in the United States by Sepsis Alliance in 2022 shows that half of first responders have very low awareness and capability of identifying a septic patient. Thomas Heymann, president of Sepsis Alliance, explained “, I know a family doctor who has become a sepsis advocate, after she almost lost her own son because sepsis wasn't on her radar. »

Diagnosing sepsis is definitely a challenge. This syndrome is characterized by an extreme immune reaction following an infection and leading to organ failure.  Training healthcare professionals across specialties is crucial, and ILAS, The UK Sepsis Trust, and Sepsis Alliance are actively involved in this effort.

The stakes are high. « If we diagnosed patients with infections earlier », emphasizes Dr Moraes, « we could save around 100,000 lives each year only in Brazil ».

In the US, sepsis now kills more children than cancer. Among those patients who survive, two in five require re-hospitalization within 90 days. Survivors often have physical and also psychological sequelae, like depression and post-traumatic stress disorder, affecting not only them but also their families.  

Beyond the public health impact, sepsis imposes a significant economic burden, costing the NHS between two and three billion pounds annually and the wider economy around 15 billion. « We’re talking about survivors who have lost limbs, carry deep trauma, and are unable to return to work. But also about people like me, those who have lost a child, who also find themselves unable to work for a time », states Melissa Mead clinical coordinator at The UK Sepsis Trust.

« There is a general sensation that we have antibiotics, so if we have infections, we are safe », says Dr Moraes. « However, every time we expose bacteria to antibiotics, they try to develop resistance to survive. »

A recent study reveals that 39 million people could die from antimicrobial-resistant infections over the next 25 years.  « Cancer or cystic fibrosis patients, who rely on antibiotics on a regular basis, are running out of drugs that can keep them alive. This is incredibly real », explains Thomas Heymann.  « . Imagine you have a kitchen fire, you reach for the fire extinguisher, and it doesn't work anymore. Your only options are to hope and pray that the fire goes out on its own. »

With that in mind, the message is clear: avoid misuse and overuse of antibiotics. Use diagnostic tools that allow to better understand what the appropriate time to use an antibiotic is, and what the appropriate antibiotic is. 

Standardized processes and protocols are part of the solution. The UK Sepsis Trust helps hospitals implement operational guidelines for sepsis and antimicrobial stewardship.  A standardized approach across the country, called the National Early Warning Score, or NEWS, helps identify acute deterioration and make treatment decisions.

In the US, Sepsis Alliance has worked with a family in the state of Maryland to pass Lochlin's Law. It requires each hospital and urgent care center to implement an evidence-based protocol for the early recognition and treatment of a patient with sepsis, severe sepsis, or septic shock. « Unfortunately, it took the death of a five-year-old boy to make this happen », regrets Thomas Heymann. « He went to urgent care with his family, and they said it was just the flu. He died 12 hours later in hospital. If there had been a diagnostic, Lochlin would still be alive. »

And in Brazil, more than 450 hospitals participate in a quality improvement program sponsored by ILAS. « We offer free software to these hospitals so they can analyze their data, and we give them feedback on points that need to be improved », explains Dr Moraes. « The good news is that AMR is not a hopeless problem. We know what to do. Now we have got to do it. »