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Infectious Diseases

Sepsis and Antimicrobial Resistance: A Complicated, Dangerous Relationship

sepsis-antimicrobial resistance-infection-amr
sepsis-antimicrobial resistance-infection-amr

Sepsis, the body’s overwhelming and life-threatening response to an infection, is one of the most significant complications of antimicrobial resistant infections.

What if water could no longer put out fire? What if, over time, fire evolved to outsmart water — this is equivalent to superbugs in the body learning to outsmart the drugs designed to defeat them.

Now, what if that fire raged uncontrolled, destroying an entire house — this is equivalent to sepsis, the body’s overwhelming and life-threatening response to infection.

Any infection has the potential to progress to life-threatening sepsis, especially if it goes untreated. Antimicrobial resistance (AMR) will become a more prominent and dangerous issue as more microbes become resistant to the antimicrobial medicines used to treat infection. These microbes, called superbugs, will put more people at risk for developing sepsis.

What is sepsis?

Sepsis, the body’s overwhelming and life-threatening response to an infection, affects an estimated 49 million people worldwide each year. In the United States, sepsis is responsible for killing at least 350,000 adults each year and is the leading cause of death in U.S. hospitals.

Sepsis can result from any bacterial, fungal, viral, or parasitic infection.

Over 50% of sepsis survivors are left with long-term physical and/or psychological effects, a condition called post-sepsis syndrome (PSS). Fatigue, reduced organ function, and post-traumatic stress disorder are all potential PSS symptoms.

An estimated 2.8 million antimicrobial resistant infections occur each year in the United States and AMR contributes to at least 10% of sepsis deaths worldwide. As more superbugs develop, these numbers will increase.

How do I know it’s sepsis?

Sepsis Alliance created a mnemonic to help remember four of the more common signs and symptoms of sepsis that should prompt one to seek emergency care: Sepsis: It’s About TIME™.

  • T – Temperature higher or lower than normal
  • I – Infection signs or symptoms
  • M – Mental decline, including being confused, sleepy, or difficult to rouse
  • E – Extremely ill, which can include severe pain, discomfort, and/or shortness of breath.

The risk of mortality from sepsis increases by 4-9% for every hour that treatment is delayed, so knowing the signs and symptoms, and seeking emergency care quickly are vital, as is having effective antimicrobials to treat the root infection.

Who gets sepsis?

Anybody with an infection is susceptible to sepsis. The very young and very old, as well as those with chronic or serious illnesses and those who are immunocompromised, are most at risk of contracting infections, including AMR infections that can develop into sepsis.

Black and “other nonwhite” individuals have nearly twice the incidence of sepsis as white individuals.

How are sepsis and AMR linked?

Just like fires that cannot be stopped, antimicrobial-resistant infections are more likely to develop into sepsis as healthcare professionals become unable to stop and treat the initial infections.

Additionally, as more superbugs develop and emerge, common medical procedures like dental surgeries, c-sections, and chemotherapy will carry a greater risk of infection, thus a greater risk of developing sepsis.

In a 2021 survey of U.S. adults conducted for Sepsis Alliance, only 51% were aware of the term “antimicrobial resistance” and 56% knew that sepsis is a potential complication of AMR. At the global level, 52% of adults were aware of the term “antimicrobial resistance” but less than half (45%) knew that sepsis is a potential complication.

Sepsis, as a leading, deadly complication of AMR, needs to be considered to shed light on the severity of AMR and why we need action now. Giving this issue the proper attention and action will save lives.

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