Sepsis is always caused by an infection, most often by bacteria, sometimes by fungi or protozoa (like malaria). That means that preventing infection is one of the best ways to prevent sepsis. For centuries, our natural immune system has served to protect us from severe infections.
Many of the advances in modern medicine actually weaken our immune system, paving the way for severe illnesses like sepsis. These include cancer-fighting (chemotherapeutic) agents; some medicines used to treat severe rheumatism, gastro-intestinal illnesses, or to suppress the body's rejection of a new organ following an organ transplant; as well as long-term use of medicines that weaken the immune system, like cortisone. People with diabetes or chronic liver or kidney diseases are also at greater risk. In addition, more and more older people are having major operations, which further weaken their immune systems and put them at risk of developing infections and sepsis.
Small children and the elderly are more susceptible to infection by pneumococcus bacteria. This can lead to pneumonia, middle ear infections, sinusitis, meningitis – and to sepsis. Today there are effective vaccines for small children that lead to immunity to major pneumococcus pathogens. Vaccinating small children leads to a greater mechanism known as "herd immunity", disrupting chains of infection and resulting in fewer pneumococcus infections even among those not vaccinated.
Vaccinations against pneumococcus bacteria, as well as meningococcus and haemophilus bacteria, are particularly important for patients who have lost their spleen or who were born without a fully functioning spleen. These people have a far greater risk of developing sepsis, and this risk remains throughout their lives. Unfortunately, most of these people have not been properly vaccinated against the bacteria that can trigger sepsis, and have not been educated about their risk. They also require prophylactic treatment with antibiotics before surgery, but that is usually overlooked.
At least 20% of the sepsis cases contracted in healthcare facilities are preventable through strict adherence to hygiene standards. That is a crucial step in reducing the incidence of sepsis. The single most important practice for doctors, caregivers, and visitors is consistently cleaning their hands with alcohol-based disinfectant before and after contact with a patient.
Another step in reducing the number of deaths resulting from sepsis is preventing bacterial resistance to antibiotics. The excessive use of antibiotics in outpatient care over the past several years has led to a drastic increase in antibiotic-resistant bacteria. This applies to bacteria on the skin (gram-positive bacteria, e.g. MRSA), but even more to fecal bacteria (gram-negative bacteria, e.g. ESBL). The danger posed by bacteria on the skin (MRSA) is vastly overestimated, as they can be treated quite easily in most cases. Appropriate steps in preventing resistance include the targeted and prudent use of antibiotics, which today are often wrongly prescribed for viral infections. Antibiotics regimens in outpatient care and other healthcare facilities are often too long, which also helps to foster resistance. The highly questionable use of antibiotics in factory farming encourages the development of multi-resistant pathogens for which hardly any effective antibiotics exist. Unfortunately, hardly any new, effective antibiotics have been developed over the last years. That's why we support every measure that contributes to the intelligent and streamlined use of antibiotics in medical care and in farming.
Insufficient hygiene conditions in resource-poor areas for giving birth, treating wounds, and in healthcare facilities in general are a tremendous problem. In some parts of the world, unsanitary facilities or contaminated water cause severe infections in the digestive system, which often end in a deadly case of sepsis.
That's why one of our key starting points is the promotion of hand hygiene and good general hygiene practices, clean deliveries, improvements in sanitation and nutrition, the delivery of clean water, as well as vaccination programs for patient populations at risk in resource-poor areas.
First state worldwide to establish statutory regulations for sepsis management ...read more