What is sepsis and how does it affect the body. Who is at risk of developing sepsis. What are the signs and symptoms of sepsis. How is sepsis treated and what are the steps for recovery.

Defining Sepsis: The Body’s Extreme Reaction to Infection

Sepsis is a critical medical condition that arises when the body’s response to infection spirals out of control. It occurs when an existing infection triggers a chain reaction throughout the body, potentially leading to tissue damage, organ failure, and death if not treated promptly. Sepsis is not contagious itself, but the underlying infections that cause it can be transmitted from person to person.

The severity of sepsis cannot be overstated. In the United States alone:

• At least 1.7 million adults develop sepsis annually
• Approximately 350,000 adults who develop sepsis die during hospitalization or are discharged to hospice
• One in three hospital deaths involve sepsis
• Nearly 87% of sepsis cases originate outside the hospital setting

The Origins and Progression of Sepsis

Sepsis typically begins with a localized infection that, if left unchecked, can escalate into a systemic problem. The most common sites for infections leading to sepsis are:

• Lungs (pneumonia)
• Urinary tract (urinary tract infections)
• Skin (cellulitis or wound infections)
• Gastrointestinal tract (appendicitis or peritonitis)

While bacterial infections are the primary culprits behind sepsis, viral infections such as COVID-19 and influenza, as well as fungal infections, can also trigger this dangerous condition.

How does sepsis develop from an infection?

When pathogens enter the body, they typically cause a localized infection. In sepsis, the immune system’s response becomes dysregulated, leading to widespread inflammation and potential organ dysfunction. This overreaction can quickly escalate, making sepsis a true medical emergency requiring immediate intervention.

Identifying High-Risk Groups for Sepsis

While sepsis can affect anyone, certain populations are at higher risk:

• Adults aged 65 or older
• Individuals with compromised immune systems
• People with chronic medical conditions (e.g., diabetes, lung disease, cancer, kidney disease)
• Those recently hospitalized or severely ill
• Sepsis survivors
• Children under one year of age

Understanding these risk factors is crucial for early detection and prevention of sepsis. Regular health check-ups and prompt treatment of infections are essential for these vulnerable groups.

Recognizing the Signs and Symptoms of Sepsis

Early detection of sepsis is critical for successful treatment. The signs and symptoms of sepsis can be subtle and may mimic other conditions, making it challenging to diagnose. However, being aware of the following indicators can save lives:

• Elevated heart rate or weak pulse
• Confusion or disorientation
• Extreme pain or discomfort
• Fever, shivering, or feeling very cold
• Shortness of breath
• Clammy or sweaty skin

Is there a definitive test for sepsis?

There is no single test to diagnose sepsis conclusively. Healthcare professionals typically use a combination of physical examination, laboratory tests, and clinical assessment to confirm the presence of sepsis. If you suspect sepsis, seeking immediate medical attention is crucial for proper evaluation and timely treatment.

Immediate Action: What to Do When Sepsis is Suspected

Sepsis is a medical emergency that requires swift action. If you or someone you know shows signs of sepsis, follow these steps:

1. Seek medical care immediately
2. Ask healthcare professionals if the infection could be leading to sepsis
3. In case of a medical emergency, call 911 and inform the operator about suspected sepsis
4. If COVID-19 is also suspected, communicate this information and wear a mask if possible

Remember, time is of the essence when dealing with sepsis. Early recognition and treatment significantly improve survival rates and reduce the risk of long-term complications.

Treatment Approaches for Sepsis

Sepsis treatment typically occurs in an intensive care unit (ICU) and involves a multi-faceted approach:

• Continuous monitoring of vital signs
• Administration of intravenous fluids
• Broad-spectrum antibiotics to combat the underlying infection
• Oxygen therapy or mechanical ventilation if needed
• Medications to support blood pressure and organ function
• In severe cases, dialysis for kidney support

How long does sepsis treatment usually last?

The duration of sepsis treatment varies depending on the severity of the condition and the patient’s response. It can range from a few days to several weeks. Some patients may require prolonged hospital stays, while others might be discharged with ongoing care and monitoring.

The Road to Recovery: Life After Sepsis

Surviving sepsis is a significant milestone, but the journey to full recovery can be challenging. Rehabilitation often begins in the hospital and continues after discharge. The recovery process focuses on:

• Gradually increasing mobility and independence
• Addressing physical symptoms such as weakness, fatigue, and pain
• Managing potential cognitive and emotional effects
• Rebuilding strength and endurance
• Adapting to any long-term changes in health or function

What are common challenges during sepsis recovery?

Sepsis survivors may face various physical and emotional hurdles during recovery, including:

• Extreme weakness and fatigue
• Breathlessness and reduced stamina
• Difficulty sleeping
• Changes in appetite and taste
• Skin and hair changes
• Emotional distress, including anxiety and depression
• Cognitive issues, such as poor concentration or memory problems

It’s essential for sepsis survivors to work closely with healthcare providers to develop a comprehensive rehabilitation plan tailored to their specific needs and challenges.

Preventing Sepsis: Strategies for Reducing Risk

While it’s not always possible to prevent sepsis, certain measures can help reduce the risk:

• Practice good hygiene, including regular handwashing
• Keep vaccinations up to date, including flu shots and pneumococcal vaccines
• Manage chronic conditions effectively
• Seek prompt medical attention for infections
• Take antibiotics as prescribed and complete the full course
• Be aware of sepsis symptoms, especially if you’re in a high-risk group

Can lifestyle changes help prevent sepsis?

Adopting a healthy lifestyle can bolster your immune system and potentially reduce your risk of infections that could lead to sepsis. Consider the following:

• Maintain a balanced diet rich in fruits, vegetables, and whole grains
• Exercise regularly to boost overall health and immunity
• Get adequate sleep to support immune function
• Manage stress through relaxation techniques or mindfulness practices
• Avoid smoking and limit alcohol consumption

By implementing these preventive measures and staying vigilant about your health, you can play an active role in reducing your risk of sepsis and other serious infections.

The Impact of Sepsis on Global Health

Sepsis is not just a personal health crisis; it’s a significant global health concern. The World Health Organization (WHO) recognizes sepsis as a priority healthcare challenge, affecting millions worldwide annually. Understanding the broader implications of sepsis can help emphasize the importance of awareness, prevention, and research efforts.

How does sepsis affect healthcare systems globally?

The impact of sepsis on healthcare systems is substantial:

• High mortality rates, particularly in low and middle-income countries
• Significant economic burden due to prolonged hospital stays and intensive care
• Strain on healthcare resources, including medical staff and equipment
• Long-term health consequences for survivors, requiring ongoing care and support

Addressing sepsis on a global scale requires coordinated efforts in research, public health initiatives, and healthcare policy to improve outcomes and reduce the overall burden of this life-threatening condition.

Advances in Sepsis Research and Treatment

The field of sepsis research is dynamic, with ongoing efforts to improve diagnosis, treatment, and outcomes. Recent advancements and areas of focus include:

• Development of rapid diagnostic tools for earlier detection
• Exploration of biomarkers to predict sepsis risk and severity
• Investigation of targeted immunomodulatory therapies
• Personalized treatment approaches based on genetic and molecular profiles
• Improved protocols for early recognition and management in healthcare settings

What promising therapies are on the horizon for sepsis treatment?

Emerging therapies and approaches for sepsis include:

• Artificial intelligence-driven early warning systems
• Novel antibiotics and antibiotic-enhancing agents
• Extracorporeal blood purification techniques
• Stem cell therapies for organ support and regeneration
• Targeted immune modulation to balance the inflammatory response

These innovative approaches hold promise for improving sepsis outcomes and potentially reducing the global burden of this critical condition.

Supporting Sepsis Survivors and Their Families

The journey through sepsis doesn’t end with hospital discharge. Survivors and their families often face long-term challenges that require ongoing support and resources. Understanding these needs is crucial for comprehensive care and improved quality of life post-sepsis.

What resources are available for sepsis survivors and their caregivers?

Several support systems and resources can help sepsis survivors and their families navigate the recovery process:

• Sepsis support groups and online communities
• Rehabilitation programs tailored for post-sepsis recovery
• Mental health services to address PTSD, anxiety, and depression
• Educational materials on long-term effects and management strategies
• Financial counseling to navigate medical expenses and potential disability
• Occupational therapy to assist with returning to work or adapting to new limitations

Engaging with these resources can significantly improve the recovery experience and help survivors regain a sense of normalcy and well-being.

The Role of Public Awareness in Combating Sepsis

Raising public awareness about sepsis is crucial in the fight against this life-threatening condition. Increased knowledge can lead to earlier recognition, prompt treatment, and better outcomes. Public health campaigns and educational initiatives play a vital role in disseminating information and potentially saving lives.

How can individuals contribute to sepsis awareness?

Everyone can play a part in increasing sepsis awareness:

• Share accurate information about sepsis symptoms and risk factors
• Participate in or organize sepsis awareness events in your community
• Support organizations dedicated to sepsis research and advocacy
• Encourage healthcare providers to prioritize sepsis education and protocols
• Share personal stories of sepsis survival to highlight the importance of early detection

By collectively working to increase understanding of sepsis, we can create a more informed and proactive approach to this serious medical condition, potentially saving countless lives in the process.

What is Sepsis? | Sepsis

• What is sepsis?
• Is sepsis contagious?
• What causes sepsis?
• Who is at risk?
• What are the signs & symptoms?
• What should I do if I think I might have sepsis?
• Fact Sheet, Brochure, and Conversation Starter

Anyone can get an infection, and almost any infection, including COVID-19, can lead to sepsis. In a typical year:

• At least 1.7 million adults in America develop sepsis.
• At least 350,000 adults who develop sepsis die during their hospitalization or are discharged to hospice.
• 1 in 3 people who dies in a hospital had sepsis during that hospitalization
• Sepsis, or the infection causing sepsis, starts before a patient goes to the hospital in nearly 87% of cases.

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency.   Sepsis happens when an infection you already have triggers a chain reaction throughout your body.  Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

Is sepsis contagious?

You can’t spread sepsis to other people. However, an infection can lead to sepsis, and you can spread some infections to other people.

Sepsis happens when…

Transcript: Sepsis happens when [TXT 1 1 KB]

What causes sepsis?

Infections can put you or your loved one at risk for sepsis. When germs get into a person’s body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Bacterial infections cause most cases of sepsis. Sepsis can also be a result of other infections, including viral infections, such as COVID-19 or influenza, or fungal infections.

Top of Page

Who is at risk?

Anyone can develop sepsis, but some people are at higher risk for sepsis:

Adults 65 or older

People with weakened immune systems

People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease

People with recent severe illness or hospitalization

People who survived sepsis

Children younger than one

Top of Page

What are the signs & symptoms?

A person with sepsis might have one or more of the following signs or symptoms:

High heart rate or weak pulse

Confusion or disorientation

Extreme pain or discomfort

Fever, shivering, or feeling very cold

Shortness of breath

Clammy or sweaty skin

A medical assessment by a healthcare professional is needed to confirm sepsis.

Top of Page

What should I do if I think I might have sepsis?

Sepsis is a medical emergency. If you or your loved one has an infection that’s not getting better or is getting worse, ACT FAST.

Get medical care IMMEDIATELY. Ask your healthcare professional, “Could this infection be leading to sepsis?” and if you should go to the emergency room.

If you have a medical emergency, call 911. If you have or think you have sepsis, tell the operator. If you have or think you have COVID-19, tell the operator this as well. If possible, put on a mask before medical help arrives.

With fast recognition and treatment, most people survive.  Treatment requires urgent medical care, usually in an intensive care unit in a hospital, and includes careful monitoring of vital signs and often antibiotics.

Top of Page

Fact Sheet, Brochure, and Conversation Starter (Print Only)

Protect Yourself and Your Family from Sepsis [PDF – 2 pages]

It’s Time to Talk about Sepsis [PDF – 2 pages]

Start the Conversation Today [PDF – 2 Pages]

Top of Page

I Survived Sepsis.

What’s Next? | Sepsis

What are the first steps in recovery?

After you have had sepsis, rehabilitation usually starts in the hospital by slowly helping you to move around and look after yourself: bathing, sitting up, standing, walking, taking yourself to the restroom, etc. The purpose of rehabilitation is to restore you back to your previous level of health or as close to it as possible. Work with your healthcare professional to determine the most appropriate rehabilitation plan and what activities are safe for you. Begin your rehabilitation by building up your activities slowly, and rest when you are tired.

How will I feel when I get home?

You have been seriously ill, and your body and mind need time to get better. You may experience the following physical symptoms upon returning home:

• General to extreme weakness and fatigue
• Breathlessness
• General body pains or aches
• Difficulty moving around
• Difficulty sleeping
• Weight loss, lack of appetite, food not tasting normal
• Dry and itchy skin that may peel
• Brittle nails
• Hair loss

You may also experience the following feelings once you’re at home:

• Unsure of yourself
• Not caring about your appearance
• Wanting to be alone, avoiding friends and family
• Flashbacks, bad memories
• Confusing reality (e. g, not sure what is real and what isn’t)
• Feeling anxious, more worried than usual
• Poor concentration
• Depressed, angry, unmotivated
• Frustration at not being able to do everyday tasks

• What are the first steps in recovery?
• How will I feel when I get home?
• What can I do to recover at home?
• Are there any long-term effects of sepsis?
• Do the effects of sepsis get better? Am I at risk for sepsis again? What should I do if I think I have sepsis again?

What sepsis survivors need to know (Print Only) [PDF – 2 pages]

Talk with your healthcare professional if you or your caregivers are concerned about any physical symptoms or feelings you are experiencing.

Top of Page

What can I do to recover at home?

Work with your healthcare professional to determine the most appropriate rehabilitation plan and what activities are safe for you. Some examples may include:

• Set small, achievable goals for yourself each week, such as taking a bath, dressing yourself, or walking up the stairs
• Rest and rebuild your strength
• Talk about what you are feeling to family and friends
• Record your thoughts, struggles, and milestones in a journal
• Learn about sepsis to understand what happened
• Ask your family to fill in any gaps you may have in your memory about what happened to you
• Eat a balanced diet
• Exercise if you feel up to it
• Make a list of questions to ask your healthcare professional when you go for a check up

Top of Page

Are there any long-term effects of sepsis?

Many people who survive sepsis recover completely and their lives return to normal. However, as with some other illnesses requiring intensive medical care, some patients have long-term effects. These problems may not become apparent until several weeks after your hospital stay and may include such consequences as:

• Insomnia, difficulty getting to or staying asleep
• Nightmares, vivid hallucinations, panic attacks
• Disabling muscle and joint pains
• Decreased mental (cognitive) function
• Loss of self-esteem and self-belief
• Organ dysfunction (kidney failure, lung problems, etc.)
• Amputations (loss of limb(s)

Talk with your healthcare professional if you have concerns about what you might experience in the weeks and months after getting home from the hospital.

Top of Page

Do the effects of sepsis get better? Am I at risk for sepsis again? What should I do if I think I have sepsis again?

Generally, the effects of sepsis do improve with time. Some hospitals have follow-up clinics or staff to help patients and families once they have been discharged. Find out if yours does or if there are local resources available to help you while you get better. However, if you feel you are not getting better or finding it difficult to cope, call your healthcare professional.

Keep in mind that people who survived sepsis are at higher risk for getting sepsis again. If you or your loved one has an infection that’s not getting better or is getting worse, ACT FAST. Get medical care IMMEDIATELY. Ask your healthcare professional, “Could this infection be leading to sepsis?” and if you should go to the emergency room. With fast recognition and treatment, most people survive.

Top of Page

Page last reviewed: August 9, 2022

Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP)

To receive email updates about this page, enter your email address:

Related Links

Antibiotic/ Antimicrobial Resistance

Antibiotic Prescribing and Use in Hospitals and Long-Term care

Healthcare-Associated Infections

Methicillin-resistant Staphylococcus aureus (MRSA) Infections

Preventing Infections in Cancer Patients

Sepsis

Sepsis

• Health Issues »
• A
• B
• C
• D
• D
• E
• Y

R

• C
• T
• U
• F
• X
• C
• H
• W
• W 9000 5
• b
• S
• B
• E
• S
• I
• Popular Topics
  • Air pollution
  • Coronavirus disease (COVID-19)
  • Hepatitis
• Data and statistics »
  • News bulletin
  • The facts are clear
  • Publications
• Find Country »
• A
• B
• C
• D
• L
• E
• Y
• W
• W
• I
• Y
• K
• L 90 005
• M
• H
• O
• R
• R
• C
• T
• U
• F

90 004 X

• C
• H
• W
• W
• L
• S
• L
• E 900 05
• Yu
• I
• WHO in countries »
  • Reporting
• Regions »
  • Africa
  • America
  • Southeast Asia
  • Europe
  • Eastern Mediterranean
  • Western Pacific
• Media Center
  • Press releases
  • Statements
  • Media messages
  • Comments
  • Reporting
  • Online Q&A
  • Events
  • Photo reports
  • Case Studies
  • Questions and answers
  • Speeches
• Update
• Emergencies ”
• News ”
  • Disease Outbreak News
• WHO data »
• Dashboards »
  • COVID-19 Monitoring Dashboard
• Basic moments ”
• About WHO »
  • CEO
  • About WHO
  • WHO activities
  • Where does WHO work?
• Governing Bodies »
  • World Health Assembly
  • Executive committee
• Main page/
• Media Center /
• Newsletters/
• Read more/
• Sepsis

©
Photo

Key facts

• The global epidemiological burden of sepsis cannot be accurately estimated. It is estimated that it develops in more than 30 million people each year and possibly kills 6 million people(1). The problem of sepsis is likely to be most prevalent in low- and middle-income countries.
• An estimated 3 million newborns and 1.2 million children suffer from sepsis each year (2). Three out of ten deaths due to neonatal sepsis are suspected to be due to drug-resistant pathogens.
• One in ten deaths due to pregnancy and childbirth are due to maternal sepsis, with 95% of maternal sepsis deaths occurring in low- and middle-income countries (4). Each year, one million newborns die due to maternal infections, in particular maternal sepsis (5).
• Sepsis may be a clinical manifestation of infections acquired both outside and inside healthcare facilities. Healthcare-associated infection is one of the most common, if not the most common, type of adverse events occurring in the course of healthcare, affecting millions of patients worldwide every year (6). Because these infections are often resistant to antibiotics, they can cause rapid clinical deterioration.

General information

Sepsis is a life-threatening organ dysfunction caused by dysregulation of the body’s response to infection (7). If sepsis is not recognized early and treated promptly, it can cause septic shock, multiple organ failure, and death. Sepsis can be caused by any type of infectious pathogen. Antimicrobial resistance is a leading factor in the lack of clinical response to treatment and the rapid development of sepsis and septic shock. Among patients with sepsis caused by drug-resistant pathogens, there is an increased risk of hospital mortality.

Who is at risk?

Anyone with an infection can develop sepsis, but vulnerable populations such as the elderly, pregnant women, newborns, hospitalized patients, and those with HIV/AIDS, cirrhosis of the liver, cancer, kidney disease, autoimmune disease, and a removed spleen are at increased risk (8).

Signs and symptoms

Sepsis is an emergency. However, the signs and symptoms of sepsis in patients may be different at different points in time, since such a clinical condition as sepsis can be caused by many pathogens and change its character at different stages. Warning signs and symptoms include a rise or fall in body temperature and chills, altered mental status, shortness/rapid breathing, rapid heart rate, slow pulse/low blood pressure, oliguria, blue or marbling of the skin, cold extremities, and severe pain or discomfort in the body (9-eleven). Suspicion of sepsis is the first step towards its early recognition and diagnosis.

Prevention

There are two main ways to prevent sepsis:
1. Prevention of microbial transmission and infection;
2. Prevention of complications of infection to the state of sepsis.

Infection prevention in the community includes good hygiene practices such as handwashing and safe food preparation, improving the quality and availability of water and sanitation, ensuring access to vaccines, especially for those at high risk of developing sepsis, and good nutrition, including breastfeeding newborns.
Prevention of nosocomial infections is generally ensured by having functioning infection prevention and control programs and appropriate teams of staff, good hygiene practices, including hand hygiene, along with cleanliness of the premises and proper operation of equipment.

Prevention of sepsis in both the community and in health care settings involves appropriate antibiotic treatment of infections, including regular assessment of patients for rational use of antibiotics, prompt medical attention, and early detection of signs and symptoms of sepsis.
The effectiveness of infection prevention is clearly supported by scientific evidence. For example, with strict hand hygiene practices in health care settings, infections can be reduced by up to 50% (12), and in public places, these interventions can reduce the risk of diarrhea by at least 40% (13). Measures to improve water supply, sanitation and hygiene (WASH) can reduce the overall burden of disease worldwide by 10% ¹⁴ . Every year, vaccinations help prevent 2–3 million infection-related deaths (15).

Diagnosis and clinical management

In order to detect sepsis early and manage it appropriately in a timely manner, it is essential to recognize and not ignore the signs and symptoms listed above, and to identify certain biomarkers (particularly procalcitonin). Post-early detection, diagnostic procedures are important to help identify the causative agent of the infection that caused sepsis, since this determines the choice of targeted antimicrobial treatment. Antimicrobial resistance (AMR) can hinder the clinical management of sepsis, as it often requires empirical antibiotic selection. Therefore, it is necessary to understand the epidemiological parameters of the spread of AMR in these settings. Once the source of the infection has been identified, the most important task is to eliminate it, for example, by draining the abscess.
Fluid therapy is also important in the early management of sepsis to normalize circulating fluid volume. In addition, vasoconstrictor drugs may be required to improve and maintain tissue perfusion. Further measures for the correct management of sepsis are selected based on the data of repeated examinations and diagnostic measures, including monitoring of the patient’s vital signs.

Sepsis and the Sustainable Development Goals

Sepsis is a major cause of maternal death, as well as death of newborns and children under five years of age. For this reason, the control of sepsis will clearly contribute to the achievement of targets 3.1 and 3.2 of the Sustainable Development Goals (SDGs).

Sepsis is a highly relevant cause of maternal death, as well as death of newborns and children under five years of age. For this reason, the control of sepsis will clearly contribute to the achievement of targets 3.1 and 3.2 of the Sustainable Development Goals (SDGs).
The indicators for achieving these two SDG targets are maternal, newborn and under-five mortality rates. Sepsis occupies an important place among the causes of these preventable deaths. It is often the clinical condition that ultimately causes death in patients with HIV, tuberculosis, malaria and other infectious diseases mentioned in target 3.3, but it is usually not recorded as a cause of death for such patients and is not included in the statistics for SDG target 3.3 indicators.
Sepsis is also important, though more indirectly, to other health-related targets under SDG 3. For example, prevention and/or proper diagnosis and management of sepsis is also relevant to adequate vaccine coverage, universal coverage of quality health services, capacity to comply with the International Health Regulations, preparedness and provision of water and sanitation services. However, achieving universal prevention, diagnosis and management of sepsis remains a challenge.

WHO activities

In May 2017, the Seventieth World Health Assembly, based on a report by the WHO Secretariat, adopted a resolution on sepsis.

Resolution WHA70.7. Improving the prevention, diagnosis and clinical management of sepsis
Report of the WHO Secretariat A70/13. Improving the prevention, diagnosis and clinical management of sepsis
Several programs at the WHO headquarters level, in collaboration and coordination with the WHO Regional Offices, are currently studying the public health impact of sepsis and providing country-level guidance and support on the prevention, early and correct diagnosis, and timely and effective clinical management of sepsis for a comprehensive response to this problem. The Global Infection Prevention and Control Team, located at WHO Headquarters in the Department of Service Delivery and Safety, coordinates sepsis activities and leads prevention efforts.

Bibliography

(1) Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med 2016; 193(3): 259-72.

(2) Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of pediatric and neonatal sepsis: a systematic review. The Lancet Respiratory medicine 2018; 6(3): 223-30.

(3) Laxminarayan R, Matsoso P, Pant S, et al. Access to effective antimicrobials: a worldwide challenge. Lancet 2016; 387(10014): 168-75.

(4) Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health 2014; 2(6): e323-33.

(5) Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). In: Black RE, Laxminarayan R, Temmerman M, Walker N, eds. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank(c) 2016 International Bank for Reconstruction and Development / The World Bank.; 2016.

(6) World Health Organization. WHO Report on the burden of endemic health care-associated infection worldwide. 2017-11-21 15:11:22 2011.

http://apps. who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf?sequence=1 (accessed April 10 2018).

(7) Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315(8): 801-10.

(8) Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. British Medical Journal 2016.

(9) United States Centers for Disease Control and Prevention. Healthcare Professional (HCP) Resources : Sepsis. 2018-02-01T06:23:15Z.

https://www.cdc.gov/sepsis/get-ahead-of-sepsis/hcp-resources.html (accessed April 10 2018).

(10) Global Sepsis Alliance. Toolkits. https://www.world-sepsis-day.org/toolkits/ (accessed April 10 2018).

(11) UK SepsisTrust. Education. 2018. https://sepsistrust.org/education/ (accessed April 10 2018).

(12) Luangasanatip N, Hongsuwan M, Limmathurotsakul D, et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. british medical journal. 2015;351:h4728.

(13) UNICEF. UNICEF Data : Monitoring the Situation of Children and Women – Diarrhoeal Disease. https://data.unicef.org/topic/child-health/diarrhoeal-disease/ (accessed April 10 2018).

(14) Pruss-Ustun A, Bartram J, Clasen T, et al. Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Tropical medicine & international health : TM & IH 2014; 19(8): 894-905.

(15) World Health Organization. Fact sheet: Immunization coverage. 2018-04-10 14:55:37.

Procalcitonin

A study aimed at detecting the level of procalcitonin in the blood for the diagnosis of sepsis, septic complications, severe bacterial infections and pyoinflammatory processes.

Synonyms Russian

Procalcitonin; biological marker procalcitonin.

Synonyms English

Procalcitonin; PCT; biomarker.

Test method

Immunochemiluminescent assay.

Units

Ng/mL (nanogram per milliliter)

What biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Eliminate alcohol from the diet for 24 hours prior to the study.
• Children under 1 year of age should not eat for 30 to 40 minutes prior to testing.
• Children aged 1 to 5 years should not eat for 2 to 3 hours prior to testing.
• Do not eat for 8 hours before the study, you can drink clean still water.
• Avoid physical and emotional stress for 30 minutes prior to examination.
• Do not smoke for 30 minutes prior to the study.

General information about the study

Procalcitonin is a prohormone, a precursor of the hormone calcitonin, which is involved in the metabolism of calcium and maintains its constant level in the blood. The procalcitonin polypeptide consists of 116 amino acids and is synthesized by C-cells of the thyroid gland. Normally, its amount is extremely small and is found in the blood in trace amounts.

In the presence of a bacterial infection, exposure to toxins increases extrathyroidal synthesis of procalcitonin by neuroendocrine cells of the liver, kidneys, lungs, muscle tissue, adipocytes, which leads to a significant increase in its level. With a systemic inflammatory response, under the influence of pro-inflammatory molecules – endotoxin, interleukins-1 and 6, tumor necrosis factor alpha – the synthesis of procalcitonin in macrophages and monocytic cells increases. The production of this biomarker can increase during the first 2-4 hours, reaching a maximum after 12 hours, the half-life is 22-26 hours. It should be noted that during a viral infection, the synthesis of procalcitonin is absent or suppressed.

The advantage of determining procalcitonin is that its synthesis in the systemic inflammatory response reaches high levels earlier than other acute phase proteins. The systemic inflammatory response or reaction syndrome is characterized by a change in body temperature greater than 38 °C or less than 36 °C, an increase in heart rate over 90 beats per minute, an increase in respiratory rate over 20 per minute, a change in the number of leukocytes in the blood (less than 4 × 10 ⁹ or more than 12 × 10 ⁹ cells per liter of blood) or by shifting the leukocyte formula to the left.

In addition to bacterial agents, severe infections caused by fungal infections and protozoa can lead to an increase in its content. In patients in intensive care units, the determination of this marker is important in severe infectious processes of various localization. In particular, with severe bronchitis, pneumonia, pancreatitis, appendicitis, peritonitis. Local inflammatory process – tonsillitis, pharyngitis, sinusitis, gastritis and others – do not lead to a diagnostically significant increase in the level of procalcitonin.

An important diagnostic value is an increase in the concentration of procalcitonin in the syndrome of multiple organ failure, sepsis, shock, especially in newborns and children. The highest values ​​are observed in sepsis, septic shock, septicemia, meningitis. Also, the levels of this biomarker increase after major surgical interventions, operations under cardiopulmonary bypass, multiple injuries, severe burns, acute transplant rejection, subarachnoid hemorrhage, and chronic heart failure. In severely ill patients, procalcitonin levels correlate with the severity of the pathological process and mortality after the disease.

Along with the assessment of the clinical course of the disease, the data of laboratory and instrumental methods of research, the detection of the level of procalcitonin can be used to determine the effectiveness of ongoing antibiotic therapy, as well as to determine the moment to stop this treatment. In patients with viral infections, allergic, autoimmune diseases, an increase in the concentration of procalcitonin occurs only in the case of a secondary bacterial infection.

What is the test used for?

• For the diagnosis of sepsis, septicemia, septic shock;
• For the diagnosis of systemic inflammatory response syndrome;
• For the diagnosis of multiple organ failure syndrome;
• For the diagnosis of severe bacterial infection of various localization;
• For the diagnosis of infectious complications in patients of surgical departments and intensive care units;
• For prescribing and monitoring the effectiveness of antibiotic therapy in patients with infectious and purulent-septic diseases.

When is the test scheduled?

• Suspected sepsis, septic shock, systemic inflammatory response syndrome, multiple organ failure syndrome;
• With symptoms of severe infectious, purulent-inflammatory processes of various localization;
• If a generalized bacterial infection is suspected in adults, children and newborns;
• If you suspect the development of infectious complications in patients in the conditions of surgical and intensive care units;
• If a secondary bacterial infection is suspected in patients with viral infections, allergic, autoimmune diseases;
• After extensive surgical interventions, operations under cardiopulmonary bypass, multiple injuries, severe burns, acute graft rejection, subarachnoid hemorrhage, chronic heart failure;
• When prescribing and monitoring specific antibiotic therapy.

What do the results mean?

Reference values: 0 – 0. 046 ng/mL.

Procalcitonin level:

> 2.0 ng/mL – high probability of severe sepsis and/or septic shock.

Causes of increase:

• Sepsis, septicemia, septic shock;
• Neonatal sepsis;
• Systemic inflammatory response syndrome;
• Multiple organ failure syndrome;
• Infectious processes of various localization: severe bronchitis, pneumonia, pancreatitis, appendicitis, peritonitis; meningitis;
• Severe infections due to fungal infection, protozoa;
• Major surgery, cardiopulmonary bypass;
• Multiple injuries, burns;
• Acute graft rejection;
• In newborns in the first 2-3 days of life after birth.

Reasons for the decrease:

• Normal levels of procalcitonin can be observed in viral infections, allergic, autoimmune diseases, local inflammatory processes.

What can influence the result?

• The use of drugs: immunosuppressants, hormonal drugs.

Important notes

• When interpreting the results of the study, it is necessary to take into account the clinical picture of the disease, the presence of concomitant diseases and complications, the use of antibiotic therapy.
• In newborns, the level of procalcitonin increases in the first 12 hours after birth, reaching a maximum within 24-36 hours, decreasing to a normal level by 4-5 days after birth. In this regard, it is recommended to repeat the study after 24 hours to exclude a generalized bacterial infection, neonatal sepsis.
• The use of drugs, in particular immunosuppressants, that increase the synthesis of pro-inflammatory cytokines, can increase the concentration of procalcitonin.

Also recommended changes)

[02-006] Urinalysis with microscopy

[06-182] C-reactive protein, quantitative (method with normal sensitivity)

Who orders the test?

Anesthesiologist-resuscitator, surgeon, oncologist, obstetrician-gynecologist, pediatrician, internist, cardiologist, infectious disease specialist.