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Sepsis on the increase in U.S., according to Emory University and CDC study

promoting thrombosis and inhibiting fibrinolysis, which is how the body breaks up clots. These changes may contribute to multiple organ failure, which is a major cause of mortality from sepsis.

Following years of research on sepsis, scientists last year introduced the first effective specific therapy the drug Xigris, which is activated protein C, a recombinant form of a natural anticoagulant. Xigris is effective because it is an anti-coagulant that also reduces inflammation. Before Xigris, the mainstay of therapy was general, broad-spectrum antibiotics and supportive care.

Physicians must be able to recognize sepsis quickly in order to treat it. "Studies show that if you wait even four to eight hours to begin antibiotic therapy, the mortality from sepsis worsens considerably," notes Dr. Martin. "And antibiotics must be appropriate. Patients with severe sepsis are in shock, with organ failure, respiratory failure, and renal failure. Although the mortality with severe sepsis is approximately 30% to 40%, Xigris reduces that to approximately 25%.

Although there has been no scientific study to identify the reasons for the increase in sepsis, Dr. Martin offers several explanations. "Physicians are identifying more cases of sepsis because they are aware of how sepsis differs from other infections," he says. "And sepsis is actually occurring more frequently due to the overuse of antibiotics and the development of resistant organisms. This is apparent in the shift towards gram-positive organisms as the cause of sepsis and the increase in fungal causes. Improvements in care among individuals with altered immunities also could be leading to an increase in sepsis. For example, antiretroviral therapy has led to increased longevity for HIV patients, and we have more patients receiving organ transplants, bone marrow transplants, and high-dose chemotherapy who are vulnerable to infection. An increase in medical and surgical procedures that breach body
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Contact: Holly Korschun
hkorsch@emory.edu
404-727-3990
Emory University Health Sciences Center
21-May-2002


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