Sepsis is a potentially life-threatening systemic inflammatory response in the presence of
infection, most commonly due to bacterial infection. It occurs predominantly among vulnerable
patients, such as elderly, immunocompromised or patients with multiple comorbidities.
Pulmonary, gastrointestinal, genitourinary, and primary bloodstream infections account for the
majority of infectious sources in septic patients. The term „systemic inflammatory response“
(SIRS) is used in cases of an evident systemic response in the absence of infection. Severe sepsis
is sepsis with dysfunction of a least one organ, and septic shock is defined as severe sepsis with
hypotension. With rising hospitalization rates sepsis clearly became a problem and has up to this
time been underestimated by the global health community. A sepsis campaign was founded by
the non-profit organization Global Sepsis Alliance to increase public and professional awareness
of sepsis. A higher incidence is particularly due to more resistant bacteria, demographic shifting
and more surgical procedures amongst others. On the 2nd October 2002 in Barcelona, intensive
care professionals from around the globe joined to reduce the number of deaths from sepsis.
Since then unfortunately the Global Burden of Disease Report (GBDR) and the WHO website
still only list “maternal sepsis” and “sepsis in new-borns”, despite the effort of the surviving
sepsis campaign. This may partly explain why most non-professionals, journalists and politicians
do not know the term “sepsis”. Successful early diagnosis and treatment remains difficult and is
one of the key features of reducing sepsis incidence. In the pathogenesis of sepsis a central
mediator does not seem to exist, although TNFα has been commonly proposed for this role.
Diagnosing sepsis includes two or more of these conditions: temperature > 38 ° C or < 36 °, heart
rate > 90 beats/min, respiratory rate > 20 breaths/min or PaCO2 < 32 torr (< 4.3 kPa), and WBC
> 12 000 cells/mm3 or < 10% immature forms. Complications of sepsis include end-organ
dysfunctions also called multiple organ dysfunction syndrome (MODS). The treatment of sepsis
requires immediate intravenous antibiotics. The initial empiric anti-infective therapy should
include one or two drugs against all possible pathogens, most commonly gram positive bacteria.