An overview of the sepsis situation in the Department of Infection Diseases, University Hospital Center, Tirana

Abstract

Background Sepsis is a condition that has been known since 2,700 years ago, but it is still a serious threat for human health [1]. Sepsis is a serious public health problem [2]. It is a complex process that can affect any individual and can originate from multiple sites and be caused by multiple microorganisms [3]. Methods We conducted a retrospective, observational study at University Hospital Center, Tirana, involving 535 critically ill patients diagnosed with sepsis admitted to the Department of Infection Diseases from January 2006 to December 2011. Blood cultures were performed on the admission day. Results During the study period there were 535 patients with sepsis admitted to our hospital. From these, 288 (53.83%) were males and 247 (46.16%) were females. In the ICU, 103 cases (19.25%) with diagnosis of sepsis or severe sepsis were admitted. The urinary tract was the predominant site of infections in 39.81% of cases, followed by the lungs in 34.95% of cases, intra-abdominal infection (not postoperative) in 15.7% of cases, soft tissues in 2.24% of cases and with unknown origin in 7.28% of cases. Organ failure (severe sepsis or multiorgan dysfunctions) was found in 37.9% of patients. Blood culture results were positive in 23% of the patients. See Table 1. Table 1 Distribution of cases with sepsis in department of infection diseases during 2006 to 2010 2006 2007 2008 2009 2010 2011 Total Cases 59 57 63 76 122 158 535 Males 34 35 27 41 69 82 288 Females 25 22 36 35 53 76 247 Mean age 44.28 47.59 44.46 40.56 48.88 49.92 45.94 Standard deviation 18.98 18.96 19.18 18.77 20.03 19.34 19.21 Conclusion Our study shows a progressive increase in the incidence of sepsis mostly in the last years. This could be explained by the possibility of increasing cases with sepsis or the doctors being affiliated with sepsis terminology. Urinary tract infection was the leading cause of sepsis. These data could be explained because our hospital is not the only center for treatment of sepsis and in our country we have another hospital for the treatment of lung diseases. The low value of positive culture results could be explained by our health system problems, using antibiotics much more than needed or antibiotic therapy being started before admission to our hospital. However, we propose that a developing country like Albania needs to develop a national center for sepsis.