Sepsis occurs in 1 -2 % of all hospitalizations and septic patients represent a significant part of intensive care unit bed utilization. Among septic populations, infection-related complications pose an increasing economic healthcare burden due to prolonged hospital stay and life-sustaining measures. A rough measure of mortality rates is 20 % for sepsis, 40 % for severe sepsis, 60 % for septic shock, and 80 % for MODS. In intensive care units, sepsis is the third most common cause of death after coronary heart disease and myocardial infarction.
A broad range of bacteria and fungi may be involved depending on the clinical condition. However, less than 30 bacteria and fungi are believed to produce more than 80% of the clinically relevant sepsis cases. Less than 50% of blood cultures of septic patients yield a positive result even when true bacterial or fungal sepsis is believed to exist.
Antimicrobial therapy is a key element in treatment of sepsis patients. In severe sepsis, there is a rapid fall in survival rate from around 80% in case of adequate antimicrobial therapy to less than 10% in case of inadequate therapy within the first 24 hours. Clinical diagnosis of sepsis can be challenging in adults and children. For instance, neonates may be relatively asymptomatic until hemodynamic and respiratory collapse is imminent. Thus, clinicians often resort to empirical antibiotic therapy if there is even a remote suspicion of sepsis until cultures are sufficiently proven to be negative since delayed diagnosis equals increased mortality and morbidity.
In clinical management antibiotic treatment is initiated along with other treatment, before the identity of the infectious agent is known. Samples are taken and sent to the microbiology lab for typing. Patients are monitored hourly. If patient status deteriorates, the patient may be transferred to intensive care and continuously monitored. When results from the lab on type of agent and later, species and antibiotic susceptibility information become available, treatment may be changed by administering a different antibiotic.