The problem of antibiotic resistance in the fight against sepsis

Please can you introduce yourself and tell us about the history of Sepsis Research FEAT? What is the role of the organization?

My name is Dr Catharina Hartman, and I am a trustee of the charity Sepsis Research FEAT. The charity was originally set up in May 2013 as FEAT – the Fiona Elizabeth Agnew Trust – by Dr Fiona Agnew’s husband Craig, with the support of six of the couple’s friends. The charity was set up in memory of Fiona and her unborn daughter Isla, who both died from sepsis in the summer of 2012.

Sepsis Research FEAT’s mission has always been to save lives and improve outcomes for sepsis patients worldwide by funding sepsis research and raising awareness. Ultimately, we want to find a cure for sepsis.

Every year almost 50 million people are diagnosed with sepsis. What is sepsis and how is it diagnosed?

In the simplest terms, sepsis is the body’s overreaction to infection. Any infection can cause this: viral, bacterial or fungal – but among the most common are pneumonia and urinary tract infections.

Infections are recognized by our immune system, which then triggers an array of responses to fight the infection, called the inflammatory response. Sepsis occurs when these normally healing responses are out of balance and affect not only the infection but everything else around it, including the body’s own tissues and organs.

Sepsis is sometimes confused with sepsis or blood poisoning. The latter is now often referred to as Bacteremia, which refers to the bacteria in the bloodstream. The term sepsis refers to a combination of negative effects resulting from an imbalanced inflammatory response.

Sepsis is the number one preventable cause of death worldwide, claiming 11 million lives annually worldwide. It’s an unprecedented, fatal condition that can kill a previously healthy adult in hours—and that’s despite all the advances in vaccines, antibiotics, and intensive care.

Especially in the early stages, sepsis can be difficult to diagnose because its symptoms are similar to other diseases.

There is currently no specific treatment for sepsis itself and identifying such treatment(s) is one of the key aims of the research, which the charity is funding through the GenOMICC project at the University of Edinburgh’s Roslin Institute.

Photo credit: Kateryna Kon/ShutterstockPhoto credit: Kateryna Kon/Shutterstock

Since sepsis occurs as an extreme response to infection, are there any groups of individuals who are at greater risk of developing the disease?

The very young and the very old are potentially more susceptible to sepsis, as are those with suppressed immune systems. Clinicians need to be aware of factors that influence clinical judgment, such as assessing alertness in people with learning disabilities, determining confusion when there is a language barrier, or the ability to spot a rash in someone with dark skin. These are just some of the factors that make it more difficult and can cause a delay in recognizing and diagnosing sepsis. However, sepsis can affect anyone at any age at any time. There just needs to be an underlying infection for the onset of sepsis to become a possibility.

Globally, one in five deaths is related to sepsis. Given this fact, why is it important to raise awareness and ensure that people are aware of the early symptoms of this condition?

In the UK, around 50,000 people a year still lose their lives to sepsis. Of the 200,000 or so who survive sepsis, about 100,000 will suffer long-term side effects and other serious consequences that affect their physical and mental well-being.

Ensuring that patients with sepsis receive timely treatment is key to improving their life expectancy and ensuring a positive prognosis. It is important that people start to recognize the symptoms of sepsis in themselves and others to ensure that they seek medical attention as soon as possible.

Image credit: Parilov/ShutterstockImage credit: Parilov/Shutterstock

The theme of World Antimicrobial Awareness Week 2022 is “Prevent Antimicrobial Resistance Together.” How does Antimicrobial Resistance (AMR) affect sepsis? Moreover, how does AMR increase the sepsis burden?

The use of antibiotics is one of the first lines of defense in treating a patient with sepsis. AMR means that the antibiotics we use are no longer effective in treating infections right away. The longer it takes to deal with the infection, the more likely it is that the inflammatory response will persist, continue to negatively affect the patient’s tissues and organs, and lead to consequences such as amputation or PTSD.

According to the World Health Organization, many deaths from sepsis are preventable. Are you hopeful that tackling antibiotic resistance can also reduce sepsis infections and deaths worldwide?

A reduction in the incidence of sepsis is linked to being able to treat the source infection quickly and effectively, and AMR makes this increasingly difficult. Addressing AMR and ensuring that the appropriate antibiotic is given at the right time is very likely to help successfully treat patients with sepsis and ensure that they have a positive outcome.

Photo credit: Sakura/ShutterstockPhoto credit: Sakura/Shutterstock

What are the next steps for you and Sepsis Research FEAT?

Sepsis Research FEAT remains committed to funding research into the understanding and treatment of sepsis through its existing partnerships and also the new research collaborations we are entering into all the time. In addition, we will continue to raise awareness of sepsis through our work with government and the public, for example by sharing individual sepsis stories.

Where can readers find more information?

You can find out more about Sepsis Research FEAT and our work by visiting our website here.

About Dr. Catherine Hartman

Dr Catharina Hartman is a consultant in emergency medicine at the Royal Aberdeen Children’s Hospital and Aberdeen Royal Infirmary. She is originally from South Africa and has lived in Scotland ever since 2006. Her interest in sepsis grew during her residency in adult critical care medicine, which led to her involvement in developing a sepsis screening assessment for children and pediatric EDs. She continues to be involved in quality improvement efforts specifically related to the treatment of sepsis.

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