Background

Sepsis is a life-threatening systemic infection which affects people of all ages. It is caused by microbes and their toxins. If the organism fails to contain the infection at its source, the toxins trigger a generalised inflammation in all organs within a few hours. Sepsis, or "blood poisoning", is not only the often-cited red streak which appears on the arm and leads to the heart. It can also occur as a complication of any infection such as pneumonia or tonsillitis. In Germany, 154,000 new cases of sepsis occur annually; in comparison, the incidence of AIDS is 17, of colon cancer 50 and of breast cancer 110 per 100,000 inhabitants.

Sepsis is one of the leading causes of mortality with a hospital mortality rate of 54%; approximately 140 patients die of sepsis and its sequelae every day. Patients are treated for an average of 16 days on the intensive care unit and for 32 days in hospital. Therapy of sepsis on the intensive care unit (ICU) uses up approximately 1.7 billion Euros annually which amounts to a third of the total ICU budget. Survivors commonly suffer from residual lesions which are estimated to incur additional indirect costs approximating 4.52 billion Euros annually. In the last 20 years, the incidence of sepsis has increased by 500% in the US. One of the main reasons for this is the growing proportion of aged in the population. The risk of sepsis also increases due to a rising number of invasive medical procedures which affect the immune system. Therefore, sepsis must be regarded as a major barrier to medical progress in a wide range of medical specialties.

Despite its considerable socio-economic importance, there is a scarcity of valid data about occurrence, risk factors and disease course, effective and safe therapy measures and adequate post-sepsis care for survivors. Although sepsis is a problem for nearly every medical specialty, it is not in the main focus in any of these. The subject of sepsis is neglected in medical school curricula and in the training of residents. Sepsis is a complex disease, and our understanding of the pathogenesis has changed considerably. However, this has not corresponded with significant advancement in the therapy of sepsis and septic shock in the last years. Only recently some progress is becoming evident. The failure of immuno-modulatory approaches in clinical studies is closely linked to the deficits in diagnosis.

In order to advance our understanding of the disease, improve its therapy and heighten awareness, we need to bundle activities in this field.