Sepsis: A Review for Infection Prevention Professionals

While everyone is at risk for sepsis, adults over 65 years of age and children younger than 1 year are more susceptible. To emphasize how important recognizing sepsis is, September is Sepsis Awareness Month in 2022, and the Centers for Disease Control and Prevention (CDC) released fact sheets for medical professionals. Raymund Dantes, MD, MPH, Sepsis Medical Officer, Medical Advisor, National Healthcare Safety Network, CDC, reviewed with Infection Control Today^® (ICT^®) what sepsis is, how to recognize it, and what to do when faced with a patient who has it.

Infection Control Today^® (ICT^®): Would you describe what is on Centers for Disease Control and Prevention’s (CDC’s) Get Ahead of Sepsis (GAOS) Protect Your Residents from Sepsis fact sheets?

Raymund Dantes, MD, MPH: CDC’s NEW Get Ahead of Sepsis (GAOS) Protect Your Residents from Sepsis fact sheets for both long-term care (LTC) nurses and LTC certified nurse assistants (CNAs) released for Sepsis Awareness Month 2022 help educate these audiences about what causes sepsis, risk factors for sepsis, how to recognize signs and symptoms of worsening infection and sepsis, how to get ahead of sepsis, and what to do if they suspect sepsis.

ICT^®: What causes sepsis?

RD: Sepsis occurs when an infection you already have triggers a chain reaction throughout your body leading to tissue damage, organ failure, and even death. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Bacteria cause most infections that lead to sepsis. Sepsis can also result from viral infections, such as COVID-19 or influenza, or fungal infections. The most frequently identified pathogens that cause infections leading to sepsis include Staphylococcus aureus, Escherichia coli, and some Streptococcus species.

COVID-19 can have a similar presentation and a similar clinical course to some forms of sepsis. Many patients who require hospitalization for COVID-19 have signs or symptoms that meet the definition of sepsis.

ICT^®: Who is at risk?

RD: Anyone can develop sepsis, but some Individuals are at higher risk for sepsis:

• Adults 65 or older
• Individuals with weakened immune systems
• Individuals with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease
• Individuals with recent severe illness or hospitalization, including due to severe COVID-19
• Individuals who survived sepsis
• Children younger than 1 year old

ICT^®: What are the signs and symptoms?

RD: A patient with sepsis might have 1 or more of the following signs or symptoms:

• High heart rate or low blood pressure
• Fever, shivering, or feeling very cold 
• Confusion or disorientation
• Shortness of breath
• Extreme pain or discomfort
• Clammy or sweaty skin

Patients with sepsis should be urgently evaluated and treated by a health care professional.

ICT^®: How can I get ahead of sepsis?

RD: As a health care professional you can:

• Know sepsis signs and symptoms to identify and treat patients early. 
• ACT FAST if you suspect sepsis.
• Prevent infections by following infection control practices (e.g., hand hygiene, appropriate catheter management) and ensuring patients receive recommended vaccines. 
• Educate your patients and their families about: 
  • Preventing infections
  • Keeping cuts and wounds clean and covered until healed
  • Managing chronic conditions
  • Recognizing early signs and symptoms of worsening infection and sepsis
  • Seeking immediate care if signs and symptoms are present

ICT^®: What should I do if I think my patient might have sepsis?

RD: Sepsis is a medical emergency. You play a critical role. Protect your patients by ACTING FAST.

• Know your facility’s existing guidance for diagnosing and managing sepsis.
• Immediately alert the health care professional overseeing care of the patient if it is not you.
• Start antibiotics as soon as possible in addition to other therapies appropriate for the patient. If a specific bacterial cause of sepsis is known, therapy should be targeted to optimize treatment and broad-spectrum antibiotics might not be needed.
• Check patient progress frequently. Treatment requires urgent medical care, usually in an intensive care unit in a hospital, and includes careful monitoring of vital signs and often antibiotics. Early and frequent reassessment of patients with sepsis should be undertaken to determine the appropriate duration and type of therapy.

With your fast recognition and treatment, most patients survive.

ICT^®: How will these fact sheets assist IPs and other clinicians?

RD: Infection preventionists (IPs) and other clinicians are encouraged to use these materials as a guide to prevent infections that can lead to sepsis, as well as to recognize signs and symptoms of sepsis to identify residents early and get them immediate treatment. These materials can be printed and posted in staff common areas or handed to staff. Free copies of the new fact sheets and other Get Ahead of Sepsis materials can be ordered in early October:

Visit CDC-Info On Demand – Publications
Select “Sepsis” from the Programs drop-down menu and click “Search,” or 

Call 1-800-CDC-INFO.

ICT^®: What else do you want to tell ICT®’s readers?

RD: Sepsis is a medical emergency. You play a critical role. Protect your residents by ACTING FAST.