Sepsis

Blood poisoning. That’s what it means, really and truly

The presence in tissues of harmful bacteria and their toxins, typically through infection of a wound, is defined as Sepsis. If you want to be fancy about it you can say all that, but it boils down to the same thing – bacteria, toxins, and poisons in blood.

Sepsis is the nightmare of every single Healthcare worker who has ever set foot in a hospital. If you have ever been to a hospital, or touched a patient, then it should be your nightmare too.

The few who work in intensive care units of even the shiniest and happiest cities in the world will have the grizzliest war stories to tell. There will be those who have watched on as a patient deteriorates and hangs on to life helped only by ventilators and there will be those whose blood runs cold when they see pus dripping off the IV lines and catheters that have been stuck into the patient with the intention of keeping him alive.

Sepsis is just a symptom of a much larger and scarier problem - the bacteria are evolving.

In the simplest terms, a patient is diagnosed with Sepsis when bacteria manage to break through all the bodies’ immune defenses and gain entrance to the blood stream. In the blood stream, they run rampant. Their own waste products act as toxins and cause the patients blood pressure to plummet. This low blood pressure state is commonly referred to as “shock”.

The state where bacteria have invaded one’s blood and are causing his blood pressures to drop is called Septic Shock. The low pressures and build up of toxins in the body plays havoc with every organ at once. The brain shuts down sending the person into a coma. The heart becomes irregular. Blood begins to clot in veins.

Sepsis is very commonly caused in the hospital environment itself - a so-called Nosocomial Infection – by bugs jumping from patient to patient in the cramped confines of a city hospital. So the longer you stay in a hospital, the higher your chances of getting it in the first place.

We do live in the age of Antibiotics, though. Since the 1930’s, we have been able to beat back the ravaging microbes and cure any infection, from an ear infection to sepsis (viral infections are the big exception to that statement. The only viral epidemics we’ve ever cured are through vaccinations by limiting the spread). Unfortunately we are now coming to the end of that age. Bacteria have learned to adapt to the antibiotics that we target them with. New antibiotics aren’t being developed by drug companies at the same rate they used to.

So we are coming to a point where bacteria may become resistant to everything we have in our arsenal. That doomsday scenario coupled with Sepsis is the stuff of any nightmare.

As of now, high level antibiotics can cure sepsis if the patient is healthy enough and the organ dysfunction  is not too bad. Any case of sepsis can be fatal and a good ICU and Critical Care team supported by good labs is very very important. Luck also helps, and it seems that in this rapidly post antibiotic world we are heading toward, luck will be increasingly important.