Sepsis dramatically on the rise in U.S.

May 21, 2002 at 8:20 AM
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ATLANTA, May 21 (UPI) -- Sepsis, a severe reaction to infection, has increased by 329 percent in the United States over the past 25 years and is now costing the nation billions in medical expenses, a new study presented Tuesday reveals.

Researchers at Emory University and the U.S. Centers for Disease Control and Prevention said their data illustrate sepsis has become a major public health problem in this country. Reviewing records from 1979 to 1999, researchers found sepsis has increased by an average of 16 percent per year. Incidents of the disease have increased from 78 cases per 100,000 people in 1979 to 259 cases during the two-decade period.

The study, which was reported the American Thoracic Society meeting, also found sepsis has crossed many demographic lines, increasing among both children and adults. Men, African-Americans and other non-Caucasians have the highest rate of hospitalizations due to sepsis. The researchers also pointed out sepsis has risen most quickly among females and Caucasians.

However, sepsis can affect everyone, researcher Dr. Greg Martin, a pulmonologist at Emory University, told United Press International. "I don't think we're at a peak. I think we're still increasing."

Sepsis typically begins with a recognizable infection, usually bacterial, viral or fungal. It triggers a severe reaction by the immune system, so severe it can cause blood clots and inflammation. Treatment can involve antibiotics or isolating the source of the infection. Martin said a new drug called Xigris, approved last fall by the Food and Drug Administration, is not an antibiotic and effectively treats severe sepsis.

Although, overall, sepsis caused by infections is uncommon, researchers said the data show it has had the greatest increase compared to sepsis cases caused by other sources.

There could be many reasons for the rise in sepsis, Martin said. Older people are living longer, but the elderly are highly vulnerable to infection. More people are living with immune system deficiencies, such as those with AIDS and patients who have undergone organ transplantation and are taking drugs to keep their immune systems from rejecting the donated organ. Both of these groups are particularly prone to sepsis, Martin explained.

"Now you've got a much greater population out there that's immunosuppressed," he said.

Also, routine use of antibacterial products and overuse of antibiotic medications could be weakening the body's natural defenses against sepsis.

"Sure, it can, that's just one of things that probably contributes to this, antibiotic resistance," Martin said, although not all experts agree antibiotic resistance is a culprit.

"Antibiotic resistance has not contributed to sepsis," said Dr. Gary Simon, director of the division of infectious diseases and a professor of medicine at George Washington University in Washington, D.C. "I don't think that has any role in increasing incidence."

Simon commented it is not "surprising that (sepsis) is increasing because we're able keep people alive who probably would have died from sepsis."

Another source of sepsis, Simon explained, would be intravenous catheters kept in patients for hours at a time to deliver chemotherapy, which can compromise the immune system. Twenty years ago, intravenous catheters for chemotherapy "didn't exist," he said.

(Reported by Katrina Woznicki in Washington)

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