Sepsis in the department of infectious diseases and febrile conditions of General hospital Celje in the years 2000–2003

Abstract

Background: The aim of our study was to establish the incidence of sepsis, as well as to identify the causes and source of infection in patients treated at the Department of Infectious Diseases and Febrile Conditions of General Hospital Celje in the years 2000–2003.

Patients and methods: By means of a retrospective research we reviewed medical records of 7,260 patients who were hospitalized in our ward in the years 2000–2003. The retrospective study revealed that 816 (11.2%) out of 7,260 patients admitted in the period 2000–2003 met the criteria for the diagnosis of sepsis. Our definition of patients with sepsis was based on additional and stricter criteria than those reported in the literature.

Results: The source of sepsis was known in all 816 patients included in the study, the causative agent was proved in 460 (56.4%) of them. Of the later, only in 70 (8.6%) patients it was isolated from hemoculture, while in the remaining 390 (47.8%) patients the causative agent was isolated from other infectious cultures. In patients with known cause of infection (460 persons), gram-negative bacteria were prevailing (332 patients, 72.2%). Considering only blood isolates (70 patients), the prevalence of gram-negative bacterial infections is less obvious, i.e. 38 cases (54.3%).

Conclusions: According to our relatively strict definition, at least one tenth of all admissions to our department are attributable to sepsis, while in the period 2000–2003, only 102 out of 816 cases of sepsis detected in our study were reported to the Epidemiological Service, which was hardly a bit more than one percent (1.4%). In the same period, only 15 additional patients with sepsis (altogether 117) were reported to the Epidemiological Service of R Slovenia from Celje health region (with approximately 220.000 population, which clearly indicates that the detection, reporting and registration of patients with sepsis is insufficient. As in Slovenia we still have not reached an agreement on the definition of sepsis, there is a great discrepancy between the number of patients diagnosed with sepsis and the number of those reported to the national Epidemiological Service. Thus, the severity of rapidly increasing number of patients with sepsis, which is nowadays ever so frequently caused by multiresistant bacteria, still remains obscure to the critical public as well as to the responsible health institutions and government authorities. The data presented call for an immediate consensus on the definition, reporting and registration of sepsis on the national level.