Clinical aspects of sepsis.

Abstract

Sepsis is still a serious threat, especially to patients hospitalized in intensive care units (ICUs). Despite advances in modern technology that lead to an improved outcome in individuals suffering from sepsis, clinicians must be cautious when the septic condition is suspected. Changes in the epidemiology, etiology and foci of sepsis, together with a rise of antimicrobial resistance in the causative agents responsible for sepsis, create a qualitatively new situation. Because the septic patient must be treated without delay, the diagnosis of sepsis is usually based on the clinical findings, the knowledge of epidemiological history and predisposing conditions. Traditional methods used in the diagnosis of sepsis must be employed and used in combination with novel approaches of diagnosis, such as the detection of DNA from pathogenic microorganisms in the sterile body fluids and routine measurements of procalcitonin levels in the serum. Since many septic patients are hospitalized in ICUs, complications associated with the development of multiple organ dysfunction/failure are important. Respiratory, circulatory and renal failures are the most frequent types of organ dysfunction in the ICU. Furthermore, secondary nosocomial infections develop in about 20-50% of ICU patients. Thus, facing sepsis is a significant challenge, even for an experienced clinician.