Rome, September 16 – In the world, every 3-4 seconds someone dies of sepsis. In these ten words, the Global Sepsis Alliance wanted to concentrate the message to be spread on the occasion of World Sepsis Day 2024, celebrated on September 13.
Sepsis – which occurs when the immune response to an infection, such as pneumonia or diarrhoea, causes damage to organs and tissues – affects around 50 million people each year, resulting in more than 11 million deaths: one in five deaths globally is associated with sepsis.
“This is a real health emergency that, in Italy alone, affects around 250,000 people a year, with a mortality rate of 25% (around 50,000 deaths in Italy in 2015, 70,000 in 2020, the year of Covid)” explains Anthony Giarratanopresident of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (Siaarti). “For this reason, Siaarti has been working since 2021 on the development of a multidisciplinary guideline on the management of sepsis and septic shock in adult patients” explains Giarratano, specifying that they contribute to the definition of the guidelines other scientific societies such as those of microbiologists (Amcli and Sim), those of infectious disease specialists (Simit and Sita), that of emergency-urgency doctors (Simeu) and that of pharmacologists (Sif).
“The work was very long and the guideline finally saw the light in July 2024, when it was published on the website of the Istituto Superiore di Sanità“ explains Andrea Cortegianihead of the Siaarti Scientific Committee and member of the panel of experts who developed the document. “To commemorate World Sepsis Day, we thought it appropriate to organize a webinar to present the document, which will remain available online in the following months”. (The event, a comparison between anesthetists-resuscitators, infectious disease specialists and microbiologists, It is available for free on Siaar’s YouTube channelof).
“The guideline emphasizes the importance of reducing the diagnostic time (Turn-around-time) thanks to rapid tests, to quickly identify the pathogen and its resistance to antibiotics” explains Daniela Pasero (in the photo), head of the Siaarti “Infections and Sepsis” section and moderator of the webinar.
“Sepsis is a time-dependent disease: early diagnosis and timely initiation of targeted therapy are crucial to reduce mortality”adds the Gianpaola Monti, head of the Siaarti Scientific Committee. “Rapid diagnosis also allows us to avoid excessive exposure to antibiotics, which can lead to the development of antibiotic resistance and reduce the adverse effects of antimicrobials.”.
Inevitably, sepsis refers to what is a true global health emergency, namely antibiotic resistance, which in our country is unfortunately more serious than elsewhere, being among the highest in Europe. Every year, almost 300,000 patients contract infections from resistant bacteria, with approximately 7,000 deaths.
“Antibiotics are prescribed too often without adequate training and without any utility, both in the community and in hospital.” he says Mark Falconeinfectious disease specialist. “In the case of sepsis, antibiotics are essential and it is necessary to choose the right one based on rapid microbiological findings, both in terms of identifying the germ and the resistance mechanisms”.
“Research and analysis of the literature demonstrate that a rapid iMicrobial identification improves outcome in patients with sepsis” he adds Stefania Stefaniamicrobiologa. “NDespite the more limited number of studies, the use of rapid tests is the direction to follow also for the antibiogram”.
The Siaarti guidelines indicate a clear path, but it is necessary to invest in adequate training and in the organization of analysis laboratories, which should guarantee an increasingly extended activity throughout the day, to guarantee timely diagnoses. A faster and more efficient management of antibiotic therapy would not only reduce mortality, but would also reduce healthcare costs, improving the care of critical patients and shortening hospitalization times.