The problem of antimicrobial resistance in sepsis control

Please, could you introduce yourself and tell us about the history of FEAT for sepsis research? What is the organization’s mission?

My name is Dr Katharina Hartmann, and I’m a trustee of the charity Sepsis Research FEAT. The charity was originally set up in May 2013 as FEAT – Fiona Elizabeth Agnew Trust – by Dr Fiona Agnew’s husband, Craig, with the support of six friends of the couple. The charity was set up in memory of Fiona and her unborn daughter, Isla, who lost their lives to sepsis in the summer of 2012.

The mission of FEAT Sepsis Research 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.

Each year, approximately 50 million people are diagnosed with sepsis. What is sepsis and how is it diagnosed?

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

The infection is recognized by our immune system, which then triggers a series of reactions to counter the infection, called the inflammatory response. Sepsis occurs when these normal healing reactions are out of balance and affect not only the infection but everything else around it, including the body’s tissues and organs.

Sometimes sepsis is confused with septicemia, or blood poisoning. The latter is often referred to as bacteremia, which refers to bacteria in the bloodstream. The term sepsis refers to a group of negative effects resulting from an unbalanced inflammatory response.

Sepsis is the number one preventable cause of death globally and causes approximately 11 million deaths annually worldwide. It’s a randomly fatal condition that can kill a once healthy adult in a matter of hours – and this despite all the advances in vaccines, antibiotics, and intensive care.

It can be particularly difficult to diagnose sepsis in the early stages because its symptoms are similar to those of other diseases.

There is currently no specific treatment for sepsis itself and identification of such a treatment/treatments is one of the main goals of the research being funded by the charity across Genomic Project at the Roslin Institute, University of Edinburgh.

Image credit: Kateryna Kon/ShutterstockImage credit: Kateryna Kon/Shutterstock

Since sepsis occurs as a severe response to infection, are there any groups of individuals more likely to develop this condition?

The very young and very old are likely to be more susceptible to sepsis, as are those with weakened immune systems. Clinicians need to be aware of factors that influence clinical judgments, such as assessing alertness in people with learning disabilities, identifying confusion when there is a language barrier, or the ability to detect rashes in someone with darker skin. These are just some of the factors that make it more difficult and can cause delays in recognizing and diagnosing sepsis. However, sepsis can strike anyone of any age and at any time. Only an underlying infection is needed for the onset of sepsis to become a possibility.

Worldwide, 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 still lose their lives to sepsis. Of the 200,000 or so who survive an episode of sepsis, about 100,000 will suffer long-term side effects and other serious outcomes affecting their physical and mental health.

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

Image credit: Parilov/ShutterstockImage credit: Parilov/Shutterstock

The theme for World Antimicrobial Awareness Week 2022 is “Preventing Antimicrobial Resistance Together”. What is the effect of antimicrobial resistance (AMR) on sepsis? Further, how does antimicrobial resistance exacerbate the burden of sepsis?

One of the first lines of defense when treating a patient with sepsis is the use of antibiotics. AMR means that the antibiotics we use are no longer effective in treating infections right away. The longer the infection is treated, the more likely it is that the inflammatory response will persist, sustaining negative effects on the patient’s tissues and organs, leading to consequences such as amputation or post-traumatic stress disorder.

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

Reducing the incidence of sepsis is associated with the ability to treat the source of infection quickly and effectively, and antimicrobial resistance makes this even more difficult. Addressing AMR and ensuring that the right antibiotic is given at the right time is very likely to help effectively treat patients with sepsis and ensure a positive outcome.

Image credit: Sakurra/ShutterstockImage credit: Sakurra/Shutterstock

What are the next steps for you and the FEAT to check for sepsis?

Sepsis Research FEAT remains committed to funding research into understanding and treating sepsis through existing partnerships And also new research collaborations that we get into all the time. In addition, we will continue to raise awareness of sepsis through our work with goverment Authorities and the general public, for example, through the participation of individuals Sepsis stories.

Where can readers get more information?

You can learn more about Sepsis Research FEAT and our work by visiting our website over here.

About Dr. Katharina Hartmann

Dr Katharina Hartmann is a Consultant in Emergency Medicine at the Royal Children’s Hospital Aberdeen and the Royal Aberdeen Infirmary. Originally from South Africa, she has been living in Scotland ever since 2006. Her interest in sepsis increased while undertaking specialist training in adult intensive care medicine, and this led to her co-development of sepsis screening assessment for children and infants presenting to the emergency department. Continue to participate in quality improvement work specifically related to sepsis treatment.

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