TUESDAY, May 21, 2002 (HealthDayNews) -- Sepsis, a potentially life-threatening infection in the bloodstream, is on the rise in the United States, partly because of increasing bacterial resistance to antibiotics.
Even though physicians have been able to reduce the percentage of people who die from the condition, the overall number of deaths is up. That's because the incidence of sepsis has more than quadrupled in the past two decades.
"The percentage of people who die from sepsis is declining from around 30 percent in 1979 to less than 20 percent now," says Dr. Greg Martin, an assistant professor of medicine at Emory University School of Medicine.
Martin presented a 21-year analysis of sepsis cases and sepsis deaths today at The American Thoracic Society's International Conference in Atlanta.
He expanded on statistics he presented last fall at the annual assembly of the American College of Chest Physicians, with his data now including all 21 years from 1979 to 1999, not just data at decade intervals. Martin used data from the National Hospital Discharge Survey, which is representative of nationwide discharge information, to get the numbers.
In 1979, according to Martin's analysis, there were 160,000 sepsis cases in the United States, and 30 percent -- or about 48,000 patients -- died. By 1999, there were 700,000 cases and fewer than 20 percent of patients died. However, total deaths approached nearly 140,000 in 1999.
Sepsis becomes more likely when an infection occurs in the body, such as a lung or urinary tract infection. It's also more likely in those with weakened immune systems, such as persons taking anticancer drugs. Sepsis can also occur after surgery.
Sepsis begins with an identifiable infection. Then the immune system kicks into high gear, setting off a cascade of events such as uncontrolled inflammation and activation of the blood coagulation system, with the promotion of dangerous clots. These events, in turn, can lead to multiple organ failure, from which many sepsis patients eventually die.
Why the dramatic rise in sepsis cases? There are at least three reasons, Martin says.
"One is the broad use of antibiotics, which brings on resistance. We've also been getting better at keeping people alive with altered immunity, such as HIV patients and bone marrow transplant patients. And we're doing more surgery and more procedures," he says.
Despite the fact that sepsis is a growing public health threat, few people are aware of it, experts say. However, it's crucial that you know the warning signs, since 80 percent of patients develop sepsis outside a hospital.
"There needs to be more sepsis education," Martin says.
If you have a known infection, be wary if you develop a fever above 101 degrees Fahrenheit, begin to breathe very quickly or notice a rapid heartbeat (above 100 beats per minute). A very high white blood cell count is another criterion used to diagnose sepsis, but, of course, lay people can't assess that.
Treatment for sepsis includes antibiotics and supportive care. Last year, the U.S. Food and Drug Administration approved a new drug, Xigris, for treatment of severe sepsis in adults.
"It's a good drug, a safe drug," Martin says. Xigris is a genetically engineered version of a human protein called activated Protein C, which helps by interfering with blood clotting.
Another sepsis expert, Dr. Wes Ely, an associate professor of medicine at Vanderbilt University School of Medicine, applauds Martin's study and says it proves experts now have "a better handle on what is happening with the numbers."
Hopefully, he adds, it will bring some much-needed publicity to the condition. "Consumers need to know if they develop signs of infection or shortness of breath, to get to a doctor as quickly as possible," Ely says.
Besides the new drug Xigris, some studies suggest treatment with corticosteroid drugs can also help treat severe sepsis in patients with ongoing septic shock problems, in which the blood pressure falls dangerously low, Ely adds.
What To Do: For more information on sepsis, check the Merck Manual or the U.S. Food and Drug Administration.
