Bacterial pathogens: Causes of sepsis

In Germany, around 85,000 people die each year because of blood sepsis - more than from stroke and heart attack combined.
Sepsis is predominantly caused by bacterial pathogens, but invasive fungi can also trigger severe systemic infections. In addition to delayed detection, the increasing spread of antimicrobial resistance poses a growing challenge.

While antibiotic-resistant bacteria are receiving increasing attention, the significance of resistant invasive fungi is still often underestimated. The improper use of antibiotics in human and veterinary medicine, as well as the use of fungicidal plant protection products (PPPs) in agriculture, promotes the development of such resistance.

In conventional sepsis diagnostics, potential pathogens are first cultured in blood cultures and then identified using microscopic, biochemical, or molecular biological methods. Initial results for bacterial pathogens are usually available after about 24 hours at the earliest, while results for fungal pathogens often take 48 to 96 hours. Additional time is required for resistance testing, such as in an antibiogram.

Since rapid results are not available during the critical early phase of sepsis, initial therapy is usually empirical. It is based on the suspected site of infection, the clinical situation, as well as local resistance data and guidelines. However, due to the increasing development of resistance, this nonspecific approach is increasingly insufficient, meaning that patients’ condition can deteriorate significantly by the time the results are available.