Sepsis: Expanding Beyond Treatment to Prevention
Kim Smith, sepsis survivor and quadruple amputee in Milton Keynes, UK.Every 3 seconds, someone in the world dies of sepsis.1,2 Affecting nearly 50 million people and claiming at least 11 million lives every year1, the disease is also a leading cause of hospitalization and morbidity.3
Many of those we read about whose lives are taken by sepsis, are children. Believe me - as a pediatrician, I know. But those over 65 years old, like my mom, are almost 13x more likely to be hospitalized due to sepsis than those under 65.4 As we take a moment to consider these sobering facts, it’s worth reminding ourselves what sepsis is: a life-threatening condition in which the body’s immune system starts to attack its own tissues and organs as the result of an infection.5,6
Sepsis is unpredictable, progresses rapidly and anyone can be at risk.5,7 Those who survive sepsis will have a shortened life expectancy and be more likely to suffer from an impaired quality of life8,9,10 - people like Kim Smith.
Before becoming a sepsis survivor, Kim was a busy woman, running multiple businesses. But a urinary tract infection she contracted on holiday quickly progressed into sepsis. Nine weeks later, she awoke from an induced coma to the news that all four of her limbs had to be amputated to save her life.
Sadly, Kim’s story is not unique. Serious long-term physical or psychological aftereffects are experienced by approximately 1 in 6 people who have had severe sepsis.11 Sepsis represents a significant public health threat. At Sanofi, we want to make Sepsis Prevention a reality, so that stories like Kim’s become increasingly rare.
We know that E. coli is the leading cause of bacterial sepsis, accounting for around 30% of all cases with a known cause.12 E. coli usually resides harmlessly in our intestines, but certain strains can nevertheless invade parts of the body where they shouldn’t be like the urinary tract or the bloodstream, leading to invasive E. coli disease, which can progress to sepsis.13
Worryingly, many of the strains that can cause invasive E. coli disease are becoming increasingly resistant to antibiotic treatments, something that is a growing public health concern for disease control agencies around the world.13,14 Currently, sepsis is understood as a problem we need to treat. We believe a shift in emphasis -from treatment to prevention - could deliver a variety of benefits and help address a serious public health threat.
This is why we have made Sepsis Prevention our mission.
Not only can prevention save lives and lessen the devastating long-term impact of sepsis, it will also lighten the load on our increasingly stretched healthcare systems which are having to battle new threats unleashed by evolving challenges such as climate change, an ageing population and global pandemics.
Our focus in this area aligns with our ambition to become an immunology powerhouse; in placing immunoscience (understanding the role of the immune system in wellness and disease) at the centre of our research and development (R&D) strategy, we hope to do our part in advancing sepsis prevention.
In this endeavor, we are leveraging our proud legacy of innovation in vaccines, united by a common goal to keep pushing the boundaries of science.
Explore more
Redefining R&D: How Immunoscience is Driving the Pipeline of the Future
Vaccines R&D
References
1Rudd, K et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020. Volume 395, Issue 10219, 200 – 21
2Global Sepsis Alliance. Sepsis. Available at: https://globalsepsisalliance.org/sepsis. Accessed: October 2024
3McDermott, K, and Roemer, M. Most Frequent Principal Diagnoses for Inpatient Stays in U.S. Hospitals, 2018. Available at: Agency for healthcare research and quality. https://hcup-us.ahrq.gov/reports/statbriefs/sb277-Top-Reasons-Hospital-Stays-2018.jsp. Accessed: October 2024
4US Centers for Disease Control and Prevention. Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospitals. Available at: https://www.cdc.gov/nchs/products/databriefs/db62.htm. Accessed: October 2024
5WHO. Sepsis. Available at: https://www.who.int/news-room/fact-sheets/detail/sepsis. Accessed: October 2024.
6Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287. PMID: 26903338; PMCID: PMC4968574.
7National Institute of General Medical Sciences. Sepsis. Available at: https://www.nigms.nih.gov/education/fact-sheets/Pages/sepsis.aspx. Accessed: October 2024
8Cuthbertson BH, et al. Mortality and quality of life in the five years after severe sepsis. Crit Care. 2013 Apr 16;17(2):R70. doi: 10.1186/cc12616. PMID: 23587132; PMCID: PMC4057306.
9Korosec Jagodic H, et al. Long-term outcome and quality of life of patients treated in surgical intensive care: a comparison between sepsis and trauma. Crit Care. 2006;10(5):R134. doi: 10.1186/cc5047. PMID: 16978417; PMCID: PMC1751058.
10Davis JS, et al. Long term outcomes following hospital admission for sepsis using relative survival analysis: a prospective cohort study of 1,092 patients with 5 year follow up. PLoS One. 2014 Dec 8;9(12):e112224. doi: 10.1371/journal.pone.0112224. PMID: 25486241; PMCID: PMC4259299.
11Iwashyna TJ, Ely EW et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010 304(16):1787-94
12Rhee, C. et al. Prevalence of Antibiotic-Resistant Pathogens in Culture-Proven Sepsis and Outcomes Associated With Inadequate and Broad-Spectrum Empiric Antibiotic Use. JAMA Netw. 2020. Open 3, e202899
13Doua J et al. Epidemiology, Clinical Features, and Antimicrobial Resistance of Invasive Escherichia Coli Disease in Patients Admitted in Tertiary Care Hospitals, Open Forum Infectious Diseases, Volume 10, Issue 2, February 2023, https://doi.org/10.1093/ofid/ofad026
14Clarke, E. et al. Unbiased identification of risk factors for invasive Escherichia coli disease using machine learning. BMC Infect Dis 24, 796 (2024). https://doi.org/10.1186/s12879-024-09669-3