Skip to Main Content

++

INTRODUCTION

++

  • The definitions of terms related to sepsis are given in Table 45–1. Physiologically similar systemic inflammatory response syndrome can be seen even in the absence of identifiable infection.

++
Table Graphic Jump Location
TABLE 45–1Definitions Related to Sepsis
++

ETIOLOGY AND PATHOPHYSIOLOGY

++

  • The sites of infections that most frequently lead to sepsis are the respiratory tract (39%–50%), urinary tract (5%–37%), and intra-abdominal space (8%–16%). Sepsis may be caused by gram-negative (50%–62% of sepsis) or gram-positive bacteria (37%–47%), as well as by fungi (5%) or other microorganisms.

  • Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa are the most commonly isolated gram-negative pathogens in sepsis. Other common gram-negative pathogens are Serratia spp., Enterobacter spp., and Proteus spp. P. aeruginosa is the most frequent cause of sepsis fatality. Common gram-positive pathogens are Staphylococcus aureus, Streptococcus pneumoniae, coagulase-negative staphylococci, and Enterococcus species.

  • Candida species (particularly Candida albicans) are common fungal etiologic agents of bloodstream infections. The 30-day mortality rate for sepsis due to candidemia was 54%.

  • The pathophysiologic focus of gram-negative sepsis has been on the lipopolysaccharide (endotoxin) component of the gram-negative cell wall. Lipid A is a part of the endotoxin molecule from the gram-negative bacterial cell wall that is highly immunoreactive ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.