Blood culture bottles: orange label for anaerobes, green label for aerobes, and yellow label for blood samples from children
Classification and external resources
Specialty Infectious disease
ICD-10 A40 – A41
ICD-9-CM 995.91
DiseasesDB 11960
MedlinePlus 000666
MeSH D018805

Sepsis () is a whole-body

  • Sepsis at DMOZ
  • SIRS, Sepsis, and Septic Shock Criteria

External links

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup; Dellinger, RP; Levy, MM; Rhodes, A; et al. (2013). "Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012" (PDF).  
  2. ^ a b c d "Sepsis Questions and Answers".  
  3. ^ a b c d e f Jui, Jonathan (2011). "Ch. 146: Septic Shock". In Tintinalli, Judith E.; Stapczynski, J. Stephan; Ma, O. John; Cline, David M.; et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7th ed.). New York:  
  4. ^ a b Deutschman, CS; Tracey, KJ (April 2014). "Sepsis: Current dogma and new perspectives".  
  5. ^ a b Patel, GP; Balk, RA (January 15, 2012). "Systemic steroids in severe sepsis and septic shock".  
  6. ^ a b c Martí-Carvajal, AJ; Solà, I; Gluud, C; Lathyris, D; Cardona, AF (12 December 2012). "Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients.". The Cochrane database of systematic reviews 12: CD004388.  
  7. ^ a b c Jawad, I; Lukšić, I; Rafnsson, SB (June 2012). "Assessing available information on the burden of sepsis: Global estimates of incidence, prevalence and mortality" (PDF). Journal of Global Health 2 (1): 010404.  
  8. ^ Martin, GS (June 2012). "Sepsis, severe sepsis and septic shock: Changes in incidence, pathogens and outcomes".  
  9. ^ a b c d Bone, R; Balk, R; Cerra, F; Dellinger, R; et al. (1992). "Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine" (PDF).  
  10. ^ a b Angus, DC; van der Poll, T (August 29, 2013). "Severe sepsis and septic shock".  
  11. ^ a b SCCM/ESICM/ACCP/ATS/SIS; Levy, MM; Fink, MP; Marshall, JC; et al. (April 2003). "2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference" (PDF).  
  12. ^ a b Felner, Kevin; Smith, Robert L. (2012). "Ch. 138: Sepsis". In McKean, Sylvia; Ross, John J.; Dressler, Daniel D.; Brotman, Daniel J.; et al. Principles and Practice of Hospital Medicine. New York:  
  13. ^ MedlinePlus Encyclopedia Sepsis. Retrieved November 29, 2014.
  14. ^ a b c Munford, Robert S.; Suffredini, Anthony F. (2014). "Ch. 75: Sepsis, Severe Sepsis and Septic Shock". In Bennett, John E.; Dolin, Raphael;  
  15. ^ Bloch, KC (2010). "Ch. 4: Infectious Diseases". In McPhee, Stephen J.; Hammer, Gary D. Pathophysiology of Disease (6th ed.). New York:  
  16. ^ Ramachandran, G (January 2014). "Gram-positive and gram-negative bacterial toxins in sepsis: A brief review".  
  17. ^ Delaloye, J; Calandra, T (January 2014). "Invasive candidiasis as a cause of sepsis in the critically ill patient".  
  18. ^ "American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis" (PDF).  
  19. ^ a b c Wacker, C; Prkno, A; Brunkhorst, FM; Schlattmann, P (May 2013). "Procalcitonin as a diagnostic marker for sepsis: A systematic review and meta-analysis".  
  20. ^ a b c d Soong, J; Soni, N (June 2012). "Sepsis: Recognition and treatment".  
  21. ^ Abraham, E; Singer, M (2007). "Mechanisms of sepsis-induced organ dysfunction" (PDF).  
  22. ^ Ranieri, VM; Rubenfeld, GD; Thompson, BT; Ferguson, ND; et al. (June 2012). "Acute respiratory distress syndrome: The Berlin definition".  
  23. ^ "Meet the new ARDS: Expert panel announces new definition, severity classes". PulmCCM. Matthew Hoffman. 
  24. ^ International Consensus Conference on Pediatric Sepsis; Goldstein, B; Giroir, B; Randolph, A (2005). "International Pediatric Sepsis Consensus Conference: Definitions for sepsis and organ dysfunction in pediatrics".  
  25. ^ a b Backes, Y; van der Sluijs, KF; Mackie, DP; Tacke, F; Koch, A; Tenhunen, JJ; Schultz, MJ (September 2012). "Usefulness of suPAR as a biological marker in patients with systemic inflammation or infection: a systematic review".  
  26. ^ Mayr, FB; Yende, S; Angus, DC (January 2014). "Epidemiology of severe sepsis".  
  27. ^ a b Satar, M; Ozlu, F (September 2012). "Neonatal sepsis: A continuing disease burden" (PDF).  
  28. ^ a b c d e f g h Ely, E. Wesley; Goyette, Richert E. (2005). "Ch. 46: Sepsis with Acute Organ Dysfunction". In Hall, Jesse B.; Schmidt, Gregory A.; Wood, Lawrence D.H. Principles of Critical Care (3rd ed.). New York:  
  29. ^ Shukla, P; Rao, GM; Pandey, G; Sharma, S; et al. (September 5, 2014). "Therapeutic interventions in sepsis: Current and anticipated pharmacological agents".  
  30. ^ Park, BS; Lee, JO (December 2013). "Recognition of lipopolysaccharide pattern by TLR4 complexes".  
  31. ^ Cross, AS (January 2014). "Anti-endotoxin vaccines: Back to the future".  
  32. ^ Fournier, B; Philpott, DJ (July 2005). "Recognition of Staphylococcus aureus by the innate immune system".  
  33. ^ Leentjens, J; Kox, M; van der Hoeven, JG; Netea, MG; et al. (June 15, 2013). "Immunotherapy for the adjunctive treatment of sepsis: From immunosuppression to immunostimulation. Time for a paradigm change?".  
  34. ^ Antonopoulou, A; Giamarellos-Bourboulis, EJ (January 2011). "Immunomodulation in sepsis: State of the art and future perspective".  
  35. ^ Nimah, M; Brilli, RJ (2003). "Coagulation dysfunction in sepsis and multiple organ system failure" (PDF).  
  36. ^ a b Marik, PE (June 2014). "Iatrogenic salt water drowning and the hazards of a high central venous pressure".  
  37. ^ a b c d Marik, PE (June 2014). "Early management of severe sepsis: concepts and controversies".  
  38. ^ Daniels, R. (11 March 2011). "Surviving the first hours in sepsis: getting the basics right (an intensivist's perspective)".  
  39. ^  
  40. ^ Hirasawa, H; Oda, S; Nakamura, M (September 7, 2009). "Blood glucose control in patients with severe sepsis and septic shock".  
  41. ^ Sterling, SA; Miller, WR; Pryor, J; Puskarich, MA; Jones, AE (26 June 2015). "The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.". Critical care medicine.  
  42. ^ Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc.  
  43. ^ a b c d e Dellinger, RP; Levy, MM; Carlet, JM; Bion, J; et al. (January 2008). "Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008".  
  44. ^ Fluids in Sepsis and Septic Shock Group; Rochwerg, B; Alhazzani, W; Sindi, A; et al. (September 2014). "Fluid resuscitation in sepsis: A systematic review and network meta-analysis".  
  45. ^ a b Perel, P; Roberts, I; Ker, K (2013). "Colloids versus crystalloids for fluid resuscitation in critically ill patients".  
  46. ^ Zarychanski, R; Abou-Setta, AM; Turgeon, AF; Houston, BL; et al. (February 2013). "Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: A systematic review and meta-analysis".  
  47. ^ Haase, N; Perner, A; Hennings, LI; Siegemund, M; et al. (2013). "Hydroxyethyl starch 130/0.38-0.45 versus crystalloid or albumin in patients with sepsis: Systematic review with meta-analysis and trial sequential analysis".  
  48. ^ Serpa Neto, A; Veelo, DP; Peireira, VG; de Assunção, MS; et al. (February 2014). "Fluid resuscitation with hydroxyethyl starches in patients with sepsis is associated with an increased incidence of acute kidney injury and use of renal replacement therapy: A systematic review and meta-analysis of the literature".  
  49. ^ Patel, A; Laffan, MA; Waheed, U; Brett, SJ (July 22, 2014). "Randomised trials of human albumin for adults with sepsis: A systematic review and meta-analysis with trial sequential analysis of all-cause mortality".  
  50. ^ TRISS Trial Group; Scandinavian Critical Care Trials Group; Holst, LB; Haase, N; et al. (October 9, 2014). "Lower versus higher hemoglobin threshold for transfusion in septic shock".  
  51. ^ Cherfan, AJ; Arabi, YM; Al-Dorzi, HM; Kenny, LP (May 2012). "Advantages and disadvantages of etomidate use for intubation of patients with sepsis".  
  52. ^ Chan, CM; Mitchell, AL; Shorr, AF (November 2012). "Etomidate is associated with mortality and adrenal insufficiency in sepsis: A meta-analysis".  
  53. ^ Gu, WJ; Wang, F; Tang, L; Liu, JC (September 25, 2014). "Single-dose etomidate does not increase mortality in patients with sepsis: A systematic review and meta-analysis of randomized controlled trials and observational studies".  
  54. ^ Volbeda M, Wetterslev J, Gluud C, Zijlstra JG, van der Horst IC, Keus F (July 2015). "Glucocorticosteroids for sepsis: systematic review with meta-analysis and trial sequential analysis". Intensive Care Med 41 (7): 1220–34.  
  55. ^ a b c American College of Critical Care Medicine; Marik, PE; Pastores, SM; Annane, D; et al. (2008). "Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: Consensus statements from an international task force by the American College of Critical Care Medicine" (PDF).  
  56. ^ a b c d Early Goal-Directed Therapy Collaborative Group;  
  57. ^ Fuller, BM; Dellinger, RP (June 2012). "Lactate as a hemodynamic marker in the critically ill.". Current opinion in critical care 18 (3): 267–72.  
  58. ^ a b Dell'anna, AM; Taccone, FS (19 June 2015). "Early-goal directed therapy for septic shock: is it the end?". Minerva anestesiologica.  
  59. ^ Rusconi, AM; Bossi, I; Lampard, JG; Szava-Kovats, M; Bellone, A; Lang, E (16 May 2015). "Early goal-directed therapy vs usual care in the treatment of severe sepsis and septic shock: a systematic review and meta-analysis.". Internal and emergency medicine.  
  60. ^ Shane, AL; Stoll, BJ (January 2014). "Neonatal sepsis: progress towards improved outcomes".  
  61. ^ Camacho-Gonzalez, A; Spearman, PW; Stoll, BJ (April 2013). "Neonatal infectious diseases: evaluation of neonatal sepsis".  
  62. ^ a b Alejandria, MM; Lansang, MA; Dans, LF; Mantaring, JB 3rd (September 2013). "Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock".  
  63. ^ Szakmany, T; Hauser, B; Radermacher, P (September 2012). "N-acetylcysteine for sepsis and systemic inflammatory response in adults".  
  64. ^ Russel, JA (October 2008). "The current management of septic shock".  
  65. ^ Best Evidence in Emergency Medicine Investigator, Group; Carpenter, CR; Keim, SM; Upadhye, S; et al. (October 2009). "Risk stratification of the potentially septic patient in the emergency department: The mortality in the emergency department sepsis (MEDS) score".  
  66. ^ Jackson, JC; Hopkins, RO; Miller, RR; Gordon, SM; et al. (November 2009). "Acute respiratory distress syndrome, sepsis, and cognitive decline: A review and case study".  
  67. ^ Lyle, NH; Pena, OM; Boyd, JH; Hancock, RE (September 2014). "Barriers to the effective treatment of sepsis: antimicrobial agents, sepsis definitions, and host-directed therapies".  
  68. ^ Munford, Robert S. (2011). "Ch. 271: Severe Sepsis and Septic Shock". In Longo, Dan L.; Fauci, Anthony S.; Kasper, Dennis L.; Hauser, Stephen L.; et al. Harrison's Principles of Internal Medicine (18th ed.). New York:  
  69. ^ a b Sutton, JP; Friedman, B (September 2013). "Trends in Septicemia Hospitalizations and Readmissions in Selected HCUP States, 2005 and 2010".  
  70. ^ Martin, GS; Mannino, DM; Eaton, S; Moss, M (2003). "The epidemiology of sepsis in the United States from 1979 through 2000".  
  71. ^ Hines, AL; Barrett, ML; Jiang, HJ; Steiner, CA (April 2014). "Conditions with the Largest Number of Adult Hospital Readmissions by Payer, 2011.".  
  72. ^ Koh, GC; Peacock, SJ; van der Poll, T; Wiersinga, WJ (April 2012). "The impact of diabetes on the pathogenesis of sepsis".  
  73. ^ Rubin, LG; Schaffner, W (July 2014). "Clinical practice. Care of the asplenic patient".  
  74. ^ Vincent, Jean-Louis (2008). "Ch. 1: Definition of Sepsis and Non-infectious SIRS". In Cavaillon, Jean-Marc; Adrie, Christophe. Sepsis and Non-infectious Systemic Inflammation: From Biology to Critical Care.  
  75. ^ Marshall, JC (July 2013). "Sepsis: Rethinking the approach to clinical research".  
  76. ^ Shear, MJ (1944). "Chemical treatment of tumors, IX: Reactions of mice with primary subcutaneous tumors to injection of a hemorrhage-producing bacterial polysaccharide".  
  77. ^ Luderitz, O; Galanos, C; Lehmann, V; Nurminen, M; et al. (1973). "Lipid A: Chemical structure and biologic activity".  
  78. ^ Heppner, G; Weiss, DW (1965). "High susceptibility of strain A mice to endotoxin and endotoxin-red blood cell mixtures".  
  79. ^ O'Brien, AD; Rosenstreich, DL; Scher, I; Campbell, GH; et al. (1980). "Genetic control of susceptibility to Salmonella typhimurium in mice: Role of the LPS gene".  
  80. ^ Poltorak, A; Smirnova, I; He, X; Liu, M-Y; et al. (1998). "Genetic and physical mapping of the Lps locus: Identification of the toll-4 receptor as a candidate gene in the critical region".  
  81. ^ Poltorak, A; He, X; Smirnova, I; Liu, MY; et al. (1998). "Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: Mutations in Tlr4 gene".  
  82. ^ a b Torio, CM; Andrews, RM (August 2013). "National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011".  
  83. ^ Pfuntner, A; Wier, LM; Steiner, C (December 2013). "Costs for Hospital Stays in the United States, 2011".  
  84. ^ "History".  
  85. ^ "About Us - About the Sepsis Alliance". Retrieved 8 October 2015. 


  1. ^ The term "ALI" appears to have fallen out of favor, based on the "Berlin definition"[22][23]



A large international collaboration entitled the "Surviving Sepsis Campaign" was established in 2002[84] to educate people about sepsis and to improve patient outcomes with sepsis. The Campaign has published an evidence-based review of management strategies for severe sepsis, with the aim to publish a complete set of guidelines in subsequent years.[43]


Sepsis was the most expensive condition treated in U.S. hospital stays in 2011, at an aggregate cost of $20.3 billion for nearly 1.1 million hospitalizations.[82] Costs for sepsis hospital stays more than quadrupled since 1997 with an 11.5 percent annual increase.[83] By payer, it was the most costly condition billed to Medicare, the second-most costly billed to Medicaid and the uninsured, and the fourth-most costly billed to private insurance.[82]


Society and culture

It was discovered in 1965 that a strain of C3H/HeJ mice were immune to the endotoxin-induced shock.[78] The genetic locus for this effect was dubbed Lps. These mice were also found to be hypersusceptible to infection by gram-negative bacteria.[79] These observations were finally linked in 1998 by the discovery of the toll-like receptor gene 4 (TLR 4).[80] Genetic mapping work, performed over a period of five years, showed that TLR4 was the sole candidate locus within the Lps critical region; this strongly implied that a mutation within TLR4 must account for the lipopolysaccharide resistance phenotype. The defect in the TLR4 gene that led to the endotoxin resistant phenotype was discovered to be due to a mutation in the cytoplasm.[81]

By the end of the 19th century, it was widely believed that microbes produced substances that could injure the mammalian host and that soluble toxins released during infection caused the fever and shock that were commonplace during severe infections. Pfeiffer coined the term endotoxin at the beginning of the 20th century to denote the pyrogenic principle associated with Vibrio cholerae. It was soon realised that endotoxins were expressed by most and perhaps all gram-negative bacteria. The lipopolysaccharide character of enteric endotoxins was elucidated in 1944 by Shear.[76] The molecular character of this material was determined by Luderitz et al. in 1973.[77]

process. Though severe systemic toxicity had already been observed, it was only in the 19th century that the specific term – sepsis – was used for this condition. purulent used the term "blood rot" for diseases linked to severe Avicenna In the eleventh century, [75] (sepsis) was introduced by Hippocrates in the fourth century BC, and it meant the process of [74] The term "σήψη"


Several medical conditions increase a person's susceptibility to infection and developing sepsis. Common sepsis risk factors include age (especially the very young and old); conditions that weaken the immune system such as cancer, diabetes, or the absence of a spleen; and major trauma and burns.[2][72][73]

Sepsis occurs in 1-2% of all hospitalizations and accounts for as much as 25% of ICU bed utilization. Due to it rarely being reported as a primary diagnosis (often being a complication of cancer or other illness), the incidence, mortality, and morbidity rates of sepsis are likely underestimated.[2