A review of the existing literature on sepsis leads to the conclusion that sepsis is still difficult to diagnose and difficult to treat, while the prevalence and mortality from sepsis increase steadily each year. In the past 20 years, the prevalence of sepsis in the United States has increased by 300% and sepsis is currently ranked 10th among all causes of death in the United States. The cost of treating patients with sepsis in the intensive care unit and the intensive care unit is 40%.

Sepsis develops as a result of a systemic inflammatory reaction of the immune system to the effects of bacterial, viral, fungal or parasitic pathogens. The inflammatory response to infection is uncontrolled, resulting in irreversible inhibition of fibrinolysis and stimulation of thrombosis. Restriction of blood flow occurs due to the formation of blood micro clots which damage tissue and contribute to the development of organic failure. This condition is classified as severe sepsis in case of multiple organ damage or septic shock in case of insufficiency of the cardiovascular system. Mortality from sepsis is 20-30% and increases to 50% in patients with septic shock.

When trying to explain the reason for the increased prevalence of sepsis, it is necessary to consider the initial infection that causes an uncontrolled inflammatory response. The spectrum of dominant pathogens has changed over the past 20 years, and sepsis is now more often caused by gram positive rather than gram negative organisms. Another aspect is the 200% increase in the incidence in the last 20 years of sepsis caused by fungi. Recently, around 5% of sepsis cases are associated with fungi. The obvious explanation for this and the increased prevalence of infections may be the irrational use of antimicrobial agents, which has led to the growth of resistant pathogens and a decrease in the protective commensal microflora. In addition, an increase in the number of invasive medical and surgical procedures contributes to the development of nosocomial infections. Some study authors demonstrate the relationship between performing invasive procedures, such as epidural anesthesia during childbirth and neonatal sepsis. Another factor that increases the prevalence of sepsis is the high incidence of infectious complications in patients with diabetes mellitus. The urgency of the obesity problem contributes to an increase in the incidence of diabetes and the International Diabetes Federation predicts that in 2025 6.3% of the population will suffer from diabetes.

The second research question is why most often the development of the infection goes to the stage of sepsis. In general, patients with an immature immune system or immunodeficiency conditions get sick with sepsis. In neonatal sepsis, a temporary failure of the newborn's immune response system predisposes to infection, particularly by gram-negative microorganisms, such as maternal immunoglobulin class M (IgM). placenta. Premature infants also have an IgG deficiency, which can lead to Staphylococcus aureus infection. A significant increase in preterm births in developed countries is alarming.

In term infants, the incidence of postnatal sepsis increases due to an increase in the population with immunodeficiency states. The immune system suffers in chemotherapy patients taking drugs to prevent transplant rejection, HIV-infected patients and the elderly representing a growing patient population, especially in the more developed countries.

As the prevalence of sepsis increases, what can be done to reduce mortality? Obviously, rapid diagnosis and isolation of the pathogen can be considered a priority for a favorable outcome, which leads to adequate control of the source of infection, rational antimicrobial therapy and an immune response. appropriate. There are conflicting opinions on the effectiveness of the appointment of activated recombinant protein C, acting on the inflammatory response. Clinical studies have shown a 6% reduction in mortality from sepsis in patients with severe sepsis, and there is currently no more effective medication. And, while seeking reliable laboratory diagnostic tests and, to a sufficient extent, effective drugs for the treatment of sepsis and mortality in hospital patients, the need to clarify relevant information on the relevance of sepsis among the most vulnerable categories of people and caregivers is obvious patients, especially nursing home staff. It is very likely that sepsis is the direct cause of death in patients with compromised immunity, but this is no less relevant to a group of patients with concurrent chronic diseases.