Question 1

What is sepsis?

Accepted Answer

Sepsis is a life-threatening condition that occurs when the body's response to an infection injures its own tissues and organs. Any infection — bacterial, viral, fungal or parasitic — can trigger sepsis. The immune system, instead of fighting infection locally, mounts an overwhelming systemic response that damages blood vessels, causes circulatory failure and leads to organ failure and death. Sepsis is the most common final pathway to death from infection.

Question 2

How many people die from sepsis?

Accepted Answer

The landmark Rudd et al. study (Lancet 2020, PMID 32105632) estimated 48.9 million sepsis cases and 11 million sepsis deaths in 2017 — approximately 1 in 5 of all global deaths. This made sepsis far more deadly than previously recognised. Sub-Saharan Africa had the highest burden, followed by South Asia and South-East Asia. Children under 5 accounted for 40% of sepsis cases and 36% of deaths.

Question 3

What are the warning signs of sepsis?

Accepted Answer

Sepsis can be recognised using the "Think Sepsis" mnemonic. Warning signs include: sudden change in mental status (confusion, drowsiness); extreme pain or distress; fever or very low temperature; fast heart rate; rapid breathing; pale, mottled or bluish skin. In children: lethargy, poor feeding, high or low temperature, fast breathing, rash. Any person with an infection who deteriorates rapidly should be considered for sepsis and treated as a medical emergency.

Question 4

Why does every hour matter in sepsis?

Accepted Answer

Sepsis progresses rapidly — organ damage is occurring from the moment of onset. Clinical studies consistently show that each hour of delay in antibiotic administration increases mortality by approximately 7-10%. This is why the Surviving Sepsis Campaign Hour-1 Bundle specifies actions that must be completed within 60 minutes of sepsis recognition: blood cultures, broad-spectrum antibiotics, fluid resuscitation, lactate measurement and vasopressors. In septic shock, mortality can reach 40-50% even with optimal care.

Question 5

What causes sepsis?

Accepted Answer

Any infection can trigger sepsis — bacterial infections are the most common cause (pneumonia is responsible for approximately half of sepsis cases), followed by urinary tract infections, abdominal infections and bloodstream infections. Viruses (including influenza, COVID-19) and fungi (Candida, Aspergillus) can also cause sepsis. People at highest risk include very young infants, older adults, the immunocompromised (cancer, HIV, transplant), pregnant women and those with chronic diseases.

Question 6

How is sepsis treated?

Accepted Answer

Sepsis treatment follows the Hour-1 Bundle: obtain blood cultures (before antibiotics if possible without delay); administer broad-spectrum intravenous antibiotics immediately; provide fluid resuscitation (30 mL/kg crystalloid) for hypotension or elevated lactate; measure lactate to assess tissue hypoperfusion; and initiate vasopressors (noradrenaline) if blood pressure fails to respond. Source control — drainage of abscess, removal of infected catheter or device — is essential and should be achieved within 6-12 hours. ICU admission is usually required.

Question 7

What is neonatal sepsis?

Accepted Answer

Neonatal sepsis occurs in the first 28 days of life and is the third leading cause of neonatal mortality globally, responsible for approximately 680,000 neonatal deaths per year. Early-onset neonatal sepsis (before 72 hours) is commonly caused by Group B Streptococcus or E. coli transmitted from the mother during delivery. Late-onset neonatal sepsis (after 72 hours) is frequently healthcare-associated, caused by Gram-negative bacilli or Staphylococcus species. Intrapartum antibiotic prophylaxis for GBS-positive mothers prevents a major share of early-onset sepsis.

Question 8

What is the Surviving Sepsis Campaign?

Accepted Answer

The Surviving Sepsis Campaign (SSC) is a global initiative launched in 2002 by the Society of Critical Care Medicine, European Society of Intensive Care Medicine and International Sepsis Forum. It publishes international guidelines for sepsis management (updated 2021), promotes the Hour-1 Bundle, trains clinicians and measures compliance and outcomes. SSC has demonstrated significant reductions in sepsis mortality in hospitals that implement its bundle-based protocols.

Question 9

What is post-sepsis syndrome?

Accepted Answer

Post-Sepsis Syndrome refers to the physical, cognitive and psychological complications that frequently affect sepsis survivors: muscle weakness and fatigue (from prolonged ICU stay, sedation and inflammation-mediated myopathy); cognitive impairment and "brain fog" (affecting 30-40% of survivors); PTSD, anxiety and depression (affecting 20-50%); and organ damage (chronic kidney disease, heart failure, lung fibrosis). These consequences persist for months to years and impose enormous costs on survivors, families and health systems. Recognition and rehabilitation are critical.

Question 10

How is sepsis related to AMR?

Accepted Answer

Antimicrobial resistance (AMR) and sepsis are deeply linked. Drug-resistant bacteria cause sepsis that is much harder to treat — when empirical antibiotic therapy fails to cover the causative organism, mortality rises sharply. ESKAPE pathogens (MRSA, carbapenem-resistant Klebsiella, Acinetobacter) commonly cause healthcare-associated sepsis that is increasingly untreatable. Simultaneously, the urgent treatment of sepsis with broad-spectrum antibiotics — necessary to save lives — is a major driver of AMR. This is the most difficult tension in infectious disease management.

Question 11

What is WHA70.7 and why does it matter?

Accepted Answer

WHA70.7 — the World Health Assembly resolution on sepsis (2017) — was a landmark political commitment: the first time the World Health Assembly recognised sepsis as a global health priority and called on all member states to develop national sepsis plans, improve recognition and clinical management, and strengthen surveillance. Co-sponsored by Germany and Uganda — representing the high- and low-income country perspectives — it validated the global burden data and catalysed national and international action on sepsis.

Question 12

How does GMJ News cover sepsis?

Accepted Answer

GMJ News tracks WHO sepsis guidance, Surviving Sepsis Campaign guidelines updates, global burden data releases and the intersection of sepsis with AMR and patient safety. PHIG's accreditation work directly addresses sepsis management protocols in Georgian hospitals — patient safety standards require sepsis recognition training, bundle implementation and outcome monitoring. The Georgian Medical Journal covers sepsis in the context of critical care quality in Georgia.

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