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Sepsis: definition, epidemiology and diagnosis

The immune system works to fight against germs (bacteria, viruses, fungi or parasites) in order to prevent an infection. If an infection occurs, the immune system tries in the first phase to fight without the need for medication. Sometimes the immune system stops the fight against the "invaders" and starts to act against their own organs. This is the beginning of sepsis, which can be defined from this perspective as a dysfunction of the organs.

Sepsis, a complex of physio-pathological and biochemical anomalies induced by infection, is a major concern for public health. In 2011, it’s treatment cost US hospitals an amount of 20 billion $. The reported incidence is steadily rising as a result of the aging population. Surviving patients often have physical, psychological and cognitive disabilities in the long term, involving medical care and other social implications.

Extensive epidemiological studies, carried out on samples of up to 6 million individuals, showed an annual incidence in the US of about 750000 cases. Certain pathogens (other than malaria parasites) preferentially multiply in the bloodstream, and sepsis occurs at the time of destruction of the integrity of host, physical or immunological hosts, with the direct entry of the pathogen into the bloodstream.

Patients are diagnosed when developing a set of signs and symptoms related to septicemia. Sepsis progresses to severe sepsis when, besides these indicators, there is also a dysfunction of the organs (examples: breathing difficulties, decreased or absent urine, abnormal liver tests, and mental condition deterioration). The septic shock is the most severe and is diagnosed when the blood pressure drops to a dangerous level.

Diagnosis of sepsis is simplified if testing is done using a Point of Care analyser such as AQT90 FLEX. It allows the detection of sepsis, by procalcitonin (PCT) testing, a precursor of calcitonin made up of 116 amino acids.

The level of procalcitonin reflects the degree of systemic inflammatory response. Bacterial endotoxins have a crucial role in the process of inducing this protein. Other factors influencing the level of PCT are: the type and size of the infected organ, the existing bacterial species, the degree of inflammation and the immune reactivity of the body. PCT is detectable within 2-4 hours of the trigger event, reaching peak levels after 12-24 hours. In the absence of a persistent stimulus, the PCT is eliminated, the half-life being 24-35 hours.

For more details on the PCT role in determining and identifying sepsis, you can access the following link: https://www.radiometer.com/en/diagnostics/sepsisdetection/pct-as-the-biomarker-of-choice-to-aid-detection-of-sepsis

 

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