Sepsis begins outside the hospital for 80% of patients, according to a recent CDC evaluation, reported in Vital Signs . CDC researchers who reviewed medical records of 246 adults and 79 children at 4 New York hospitals in Albany and Rochester found that 7 in 10 patients with sepsis had recently used health care services or had chronic diseases requiring frequent medical care.
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Sepsis is most common in adults aged ≥ 65 years, infants < 1 year, people with weakened immune systems, or people with chronic conditions, such as diabetes. Nearly all the adults (97%) had at least 1 comorbidity, and 70% of children who developed sepsis had a health condition that may have put them at risk.
Although multiple infections and organisms were implicated, Staphylococcus aureus , Escherichia coli , and some types of Streptococcus were identified most often. Among adults with sepsis, 35% had a lung infection, 25% had a urinary tract infection, 11% had a gastrointestinal infection, and 11% had a skin infection.
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Most of the patients had recent interactions with the health care system before admission with sepsis, which likely reflects their vulnerability to infection, the researchers say, “it also suggests that health care facilities and providers could play a central role in sepsis prevention.” The CDC report advises the following for health care providers:
- Follow infection control requirements;
- Ensure that patients receive recommended vaccines (such as flu and pneumococcal);
- Educate patients and families, stressing the need to seek care if they see signs of severe infection or sepsis;
- “Think sepsis”—know the signs and symptoms and treat them early;
- Act fast—order tests to identify infection, start antibiotics and other care immediately; document dose, duration, and purpose; and
- Check patient progress frequently; reassess antibiotic therapy at 24 to 48 hours or sooner to change therapy if needed