World Antimicrobial Awareness Week 2022: The problem of antibiotic resistance in sepsis control

World Antimicrobial Awareness Week 2022: The problem of antibiotic resistance in sepsis control

Thought leaderDr. Catharina HartmannMedical TrusteeSepsis Research FEATAs part of World Antimicrobial Resistance Week 2022, News-Medical speaks to Dr. Catharina Hartman, a trustee of the charity Sepsis Research FEAT, on the issues surrounding tackling sepsis caused by antibiotic resistance.

Can you please introduce yourself and tell us about the history of Sepsis Research FEAT? What is the mission of the organization?

My name is Dr. Catharina Hartman and I are trustees of the charity Sepsis Research FEAT. The charity was originally founded in May 2013 as FEAT – the Fiona Elizabeth Agnew Trust – by Craig, husband of Dr. Fiona Agnew, founded with the support of six of the couple's friends. The charity was founded in memory of Fiona and her unborn daughter Isla, who both died of sepsis in the summer of 2012.

Sepsis Research FEAT's mission has always been to save lives and improve outcomes for sepsis patients worldwide by funding and raising awareness of sepsis research. Ultimately, we want to find a cure for sepsis.

Nearly 50 million people are diagnosed with sepsis every year. What is sepsis and how is it diagnosed?

Simply put, sepsis is the body's overreaction to an infection. All infections can cause this: viruses, bacteria or fungi - but the most common include pneumonia and urinary tract infections.

Infections are recognized by our immune system, which then initiates a cascade of reactions to counteract the infection, called the inflammatory response. Sepsis occurs when these normally healing responses become out of balance, affecting not just the infection but everything else around it, including the body's tissues and organs.

Sepsis is sometimes confused with septicemia or sepsis. The latter is now often referred to as bacteremia, which refers to the bacteria in the bloodstream. The term sepsis describes the constellation of negative effects that result from the unbalanced inflammatory response.

Sepsis is the leading cause of preventable death worldwide, causing the loss of approximately 11 million lives worldwide each year. It is an indiscriminate, deadly condition that can kill a previously healthy adult in a matter of hours - despite advances in vaccines, antibiotics and intensive care.

Sepsis can be difficult to diagnose, especially in its early stages, due to the similarity of its symptoms to those of other diseases.

There is currently no specific treatment for sepsis itself, and identifying such treatment(s) is one of the main aims of the research the charity is funding through the GenOMICC project at the Roslin Institute at the University of Edinburgh.

Since sepsis occurs as an extreme response to infection, are there groups of people who are at higher risk?

The very young and very old may be more susceptible to sepsis, as may people with weakened immune systems. Physicians need to be aware of the factors that influence clinical judgment, such as: For example, assessing attention in people with learning disabilities, determining confusion when faced with language barriers, or the ability to recognize a rash in people with dark skin. These are just a few factors that can complicate and delay recognition and diagnosis of sepsis. However, sepsis can affect anyone at any age at any time. There only needs to be an underlying infection for sepsis to occur.

One in five deaths worldwide is associated with sepsis. Given this, why is it important to raise awareness and ensure people are aware of the early symptoms of this condition?

Around 50,000 people still lose their lives to sepsis every year in the UK. Of the approximately 200,000 who survive an episode of sepsis, approximately 100,000 suffer long-term side effects and other serious consequences that affect their physical and mental well-being.

Ensuring that patients with sepsis receive timely treatment is key to improving their chances of survival and ensuring a positive prognosis. It is important that people begin to recognize the symptoms of sepsis in themselves and others to ensure they seek medical attention as quickly as possible.

The theme of World Antimicrobial Awareness Week 2022 is “Preventing antimicrobial resistance together.” What effect does antimicrobial resistance (AMR) have on sepsis? Additionally, how does AMR worsen the burden of sepsis?

The use of antibiotics is one of the first lines of defense when treating a patient with sepsis. AMR means that the antibiotics we use are no longer effective in treating infections immediately. The longer it takes to fight the infection, the more likely it is that the inflammatory response will continue, perpetuating the negative effects on the patient's tissues and organs and leading to consequences such as amputations or PTSD.

According to the World Health Organization, many sepsis deaths are preventable. Are you hopeful that combating antibiotic resistance can also reduce sepsis infections and deaths worldwide?

Reducing the incidence of sepsis is related to the ability to treat an original infection quickly and effectively, and AMR makes this increasingly difficult. Combating AMR and ensuring that the appropriate antibiotic is administered at the right time is very likely to contribute to the effective treatment of patients with sepsis and ensure that they achieve a positive outcome.

What are the next steps for you and Sepsis Research FEAT?

Sepsis Research FEAT remains committed to funding research into understanding and treating sepsis through its existing partnerships and also new research collaborations that we are constantly entering into. Additionally, we will continue to raise awareness of sepsis through our work with Government agencies and the general public, for example through sharing individual Sepsis stories.

Where can readers find more information?

You can find out more about Sepsis Research FEAT and our work on our website here.

About Dr. Catharina Hartman

Dr. Catharina Hartman is a consultant in emergency medicine at the Royal Aberdeen Children’s Hospital and Aberdeen Royal Infirmary. Originally from South Africa, she has lived in Scotland ever since2006. Her interest in sepsis expanded during her residency in adult critical care medicine and this led to her involvement in the development of a sepsis screening assessment for babies and children presenting to the emergency department. She continues to be involved in quality improvement work specifically related to the treatment of sepsis.

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