A recent randomized controlled trial authored by ESA President Prof Evangelos J Giamarellos-Bourboulis MD, PhD et al was published in Lancet Respiratory Medicine. In the study, 267 patients with community-acquired pneumonia were randomized to treatment either with clarithromycin and standard-of-care antibiotics or placebo and standard-of-care antibiotics. Clarithromycin treatment provided enhanced anti-inflammatory benefit the first 72 hours after randomization. Benefit from clarithromycin treatment was further expanded to reduction of risk of progression to organ dysfunction and secondary sepsis. Clinical benefit was associated with reversal of the complex immune dysregulation of community-acquired pneumonia. 

Please access the study for free via the button below until 21 February.

Our friends from ‘Sepsis en daarna’ from the Netherlands have published a new resource on sepsis, called the ‘Sepsis Alarm Boek’.

The booklet contains contributions from former patients, relatives, the bereaved, as well as experts in the field. Amongst them Dr. Ron Daniels, Vice-President of the GSA, and Dr. Carolin Fleischmann-Struzek, researcher and author of various articles and studies about the burden of sepsis.

The booklet was distributed amongst the Members of Parliament who are spokespersons in the field of public health, the Minister and Secretary of Public Health, and the Prime Minister. The aim is to plea for a national plan, enhancing sepsis awareness, research, and aftercare, including a public campaign.

The booklet is available free of charge and can be accessed and downloaded here in full.

To celebrate World Antimicrobial Resistance (AMR) Awareness Week #WAAW, the ESA is making CME credits available for the webinar series “Antimicrobial stewardship, a role for biomarkers”.

The webinars took place on 16, 26 October and 9 November (more information via the button below), but if you have missed them, recordings will be available for the next six months and you will still be able to request CME credits. In order to request your CME credits, you must have either attended live or watched the recording of all three webinars. To watch the recordings, please register here and then access the recordings via the button below. Afterwards, please follow this procedure:

1. Download the CME certificate request form.

2. Download the EACCME® participant’s evaluation form.

3. Fill both documents and send them together to esa@global-sepsis-alliance.org

4. The ESA Secretariat will do technical checks to verify that you have attended the webinars and will send you back the CME certification for all three webinars.

Each of the three webinars have been accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 1.5 European CME credits (ECMEC®s). Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.

Through an agreement between the Union Européenne des Médecins Spécialistes and the American Medical Association, physicians may convert EACCME® credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME® credit to AMA credit can be found at https://edhub.ama-assn.org/pages/applications.

Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME® for ECMEC®s are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

Information regarding the conversion of EACCME® credits

Credit will be converted based on one (1) hour of participation equalling one credit for all activities. Physicians wishing to convert EACCME® credits to AMA PRA Category 1 CreditTM will be required to access the AMA website at https://edhub.ama- assn.org/pages/applictations to obtain the necessary paperwork and instructions. Physicians and other health care professionals will be required to pay a processing fee to the AMA.

For other countries, please contact the relevant national/regional accreditation authority.

Five major European societies published a letter on Intensive Care Medicine asking European policymakers to support the integration of sepsis in the work plan of the European Centre for Disease Prevention and Control (ECDC), after the recently agreed extension of the agency’s mandate.

The European Sepsis Alliance (ESA), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the European Society of Anesthesiology and Intensive Care (ESAIC), the European Society for Intensive Care Medicine (ESICM) the European Society for Pediatric and Neonatal Intensive Care (ESPNIC), observe that the importance of sepsis and the correlation with infectious diseases is not yet reflected in the work of the European body in charge of monitoring and surveilling their development, spread and burden.

Estimates extrapolated from a Swedish study of 2015 suggest that in Europe more than 3 million people suffer from sepsis each year resulting in 680,000 deaths, a higher burden compared to other conditions such as stroke or coronary diseases. Sepsis is also a huge burden for European health systems and society.

The ECDC’s mandate was extended in 2022 as part of Europe’s response to the pandemic and to improve preparedness and response to future threats.

“With the revision of the ECDC mandate, the EU now has the opportunity to set new standards for sepsis care”, write the authors. “Any strategy aiming at tackling communicable diseases cannot prescind from including sepsis prevention and treatment.”

The letter recommends the following concrete actions:

• Sepsis should be considered as one of those “special health issues” mentioned in the ECDC’S extended mandate, such as AMR and healthcare-associated infections (HAIs), because of its close interlink with these public health threats and with communicable diseases.

• ECDC should also use its influence to include sepsis among the research priorities for EU-funded programs, and to include sepsis management in guidelines for the case management of communicable diseases.

• Finally, sepsis should be considered as an extremely valuable indicator for the capacity of health systems to diagnose, prevent and treat communicable diseases and their burden.

The European Sepsis Alliance will host a series of three webinars on 16 and 26 October, and 9 November on the challenges and solutions of antimicrobial stewardship, with the aim to raise awareness on antibiotic surveillance and the role of biomarkers to limit the emergence of antimicrobial resistance. 

Continuing medical education (CME) credits will be available. The webinars will be broadcasted live and recorded.

Check the programme below and register via the online form.

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Register now

I felt like Superwoman, strong and invincible! Running my own catering company with my husband, working over 60 hours a week, but never skipping my daily 6:15 am run, and in my free moments playing with my five-year-old daughter. I had just turned 40, but I have never been in better shape. Unbreakable… until July 16th, 2021.

The day before, everything was as usual: starting my day at 6.15 am with a 10km run. After breakfast, I brought my daughter to summer school, and it was just another typical busy high-season day on sunny Minorca. After work, we enjoyed a Spanish family dinner at 10 pm, as my mother-in-law was going to fly back to the mainland the morning after.

At 4 am, I woke up with a funny feeling in my tummy. Not sure if I am just hungry or feeling sick, I went to the kitchen to eat a banana. Ten minutes later, I start vomiting and have diarrhea. After that, my health was declining rapidly. At 7 am, I can just crawl the two meters between the bathroom and my bed. My mother-in-law has canceled her flight and started calling for an ambulance. I felt like flying and could barely move. Because no medical is coming and neither does the ambulance, my mother-in-law makes me an ORS. Finally, at 11 am, I stopped vomiting and was able to drink some water.

At 11:30 am, I had the honor of a cranky doctor and a clumsy nurse next to my bed. My blood pressure was on the floor and my fever was through the roof. Diagnosis without any test: COVID-19 (what else?). The order is to isolate me, and a COVID-19 ambulance will pick me up as soon as possible. After tens of calls, my mother-in-law throws in her final weapon, telling them that she will call the police if they do not send an ambulance immediately because I am on edge. Just 15 minutes later, I lost consciousness for a moment while they try to get me to the ambulance in a wheelchair.

At the hospital I do not show any progress, my blood pressure keeps on dropping and my heart rate is going up. During the X-ray, I passed out again. My caring emergency doctor brought the head of the ICU to my bed, and he takes me to his unit at 11:30 pm. In less than 24 hours I went from doing perfectly fine to the ICU. Diagnosed with severe sepsis and septic shock with multi-organ failure, of unknown origin (definitely not COVID-19!). I will turn out to be the most annoying ICU patient ever, as I hardly sleep.

The super friendly and caring head of the ICU tells me that I have been amazingly lucky and that having a strong (runners) heart probably saved my life. My good physical shape and 2 guardian angels on each shoulder make me recover almost as quickly as I got ill. After only 3 days in the ICU and one in the traumatology unit (the only free bed because of COVID-19), I asked to go home. Before going, I asked my doctor if there is any risk if I go for a run next week…

I never imagined the battle that was waiting for me. Hospital dismissal was just the beginning of my recovery. To be very clear: I was extremely lucky to get out of a septic shock like I did. But the road to recovery has been a fight, full of tears, fears, and frustration. And mostly, it has been a lonely road without any understanding and information from medical professionals. There is near to nothing available for sepsis patients in Spain.

That made me decide to do something and use my experience for something worthy. Being Dutch and understanding English, I could contact ¨Sepsis en daarna¨ in the Netherlands and the European Sepsis Alliance and read about sepsis. After going to medical specialists and getting no answers or conflicting information about my sequelae, reading the ESA’s “Life after sepsis guide” made me realize that I am not crazy, and I am definitely not the only one. Although Superwomen died in the ICU, I am determined to make Spanish sepsis survivors feel the same: together the battle is more bearable!

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The article above was written by Marianne Haverkamp and is shared here with her explicit consent. The views in the article do not necessarily represent those of the European Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team at the ESA and World Sepsis Day wishes to thank Marianne for sharing her story and for fighting to raise awareness for sepsis. The text has been lightly edited for clarity.

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E. Giamarellos

At the 6th ESA Annual Meeting that took place in Brussels on 21 March, ESA Chair Evangelos Giamarellos called on national and European institutions and authorities to help improve sepsis care in Europe via a list of actions pertaining to their responsibilities. The call, available here and via the button below, asks for concrete measures to support research, awareness, education, quality improvement, antimicrobial stewardship, support for survivors and political focus on sepsis. The ESA calls on other organisations to join the call.

K. Björkqvist

The day started with the story of Kristina Björkqvist. She had sepsis twice, once in 2007 and another time in 2016 that affected her more severely and from which she still suffers the long-term consequences. Kristina shared her experience and her work on engaging with other sepsis survivors that brought them to set up a Swedish patient association.

K. Reinhart, E. Giamarellos, V. Andriukaitis, H. Beton.

Education, data, impact measurement and collaboration are the words coming out of a beautiful day of discussions, learnings and togetherness. We were honoured to host former European Commissioner for Health and Food Safety, and now WHO Special Envoy for Europe, Vytenis Andriukaitis. He shared his unique passion for improving health for all Europeans. When asked what can be done to improve sepsis awareness and quality of care, he is sure that communication towards policymakers and media must be intensified, also in relation to the current global health threats and policy priorities, such as AMR, infectious diseases, cancer, with which sepsis has strong links. ESA Chair Evangelos Giamarellos insisted on the importance of education, both towards the public, but most importantly for healthcare professionals. Moderator Hatice Beton questioned the panellists on the potential benefits that digitalisations could bring to sepsis care. Speakers agreed that better data collection thanks to technology is key, but it must be accompanied by the will and the resources to use those data to really improve patent care. GSA founder and past president, Konrad Reinhart described the challenges to correctly communicate about sepsis, especially by policymakers. He closed the first panel with an optimistic note. He reminded of the huge progress made so far by sepsis advocacy, and he stressed that more needs to be done, also by breaking silos and unite with other advocacy groups and organisations.

C. Scheer

The picture of the quality of sepsis care is not the brightest. Procedures for early recognition are not sufficiently widespread. The offer of microbiological laboratory services is too often time limited, which causes significant delay in pathogen identification and therefore in effective treatment. Overall, quality improvement initiatives do not follow a structural path. These are the conclusions of the European Sepsis Care Survey, conducted by Christian Scheer, covering more than 1000 hospitals in Europe. Conclusions mirrored somehow also by the European Sepsis Report, updated in occasion of the event, that shows that in only 11 European countries there are ongoing initiatives on sepsis, of which only four are government-led national sepsis plans.

A. Artigas

L. Schlapbach

The programme looked at specific issues related to two of the most vulnerable groups: elderly and children. The presentation of Antonio Artigas illustrated the challenges that an ageing population brings to sepsis management. Elderly patients are more vulnerable to sepsis due to several factors, including their unique vascular system and the fact that they often receive other treatments and medications. Sepsis symptoms are also different by the elderly. Luregn Schlapbach instead explained how difficult it is to detect sepsis in children, because of their incapacity to communicate deterioration, and the lack of focus on children in currently ongoing national sepsis plans in Europe. In this context, parents participation in discussions and in the clinical management of small sepsis patients is paramount.

K. Björkqvist, E. Ozcelik, R. Daniels

However, data show that sepsis is not a prerogative of one or the other population group, shared Ron Daniels, UK Sepsis Trust CEO and GSA Vice President, who moderated the final panel, which drew parallels between sepsis and COVID-19, in terms of impact on the health systems and on people. Because of the lack of available data, OECD’s work does not focus on sepsis. However, the data shared by Ece Ozcelik on the impact of infectious diseases and AMR on the G7 economies are impressive: AMR is costing every year twice as much the cost of HIV treatment, and these figures are deemed to increase. The impact of the pandemic was big for patients and for family doctors. Thiago Villanueva highlighted the need for GPs to be prepared to deal with emergency situations. Integrating point of care diagnostic tools into clinical systems is key to help GPs identify pathogens and provide the right therapy, be it for sepsis or other conditions. As often argued by ESA, the impact of COVID-19 on the sepsis burden is significant, considering that the vast majority of ICU-treated COVID-19 cases presented a viral sepsis. However, because of recent changes in the ICD coding system, it was impossible to record those cases as sepsis, argued Caroline Fleischmann, from the Jena University Hospital. Her study from 2021 also looked at the heavy long-term consequences of sepsis: within the twelve months following sepsis, 3/4 of patients require care for conditions that they did not have before and 1/3 cannot return to work within the same period. Participants raised the point on the need to focus on rehabilitation of patients, as the extended economic impact on the society can be huge. Kristina wished for clinical hubs where patients can receive appropriate support from trained professionals, similarly to what is being set up for long Covid. Of course, this might come with a cost, but it should rather be seen as an investment, because, as it was rightly pointed out, the cost of non-action can be far bigger.

In this regard, the event moderator Ulrika Knutsson announced plans by ESA to run an economic impact assessment study and asked supporters to get in touch as we are seeking funding for this project.

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The 6th ESA Annual Meeting was kindly sponsored by

Join ESA Patron Vytenis Andriukaitis and other high-level speakers for the 6th Annual Meeting of the ESA. This year, we will discuss with policymakers, experts, and sepsis survivors what it takes to integrate sepsis into the broader picture of European health policies. Panellists and participants will reflect on the importance of including sepsis (research, education, awareness, treatment, and patient support) in strategies and initiatives on infection prevention and control, AMR, pandemic preparedness and patient safety, and discuss how European institutions and agencies can support member states.

The event will take place at the same venue of the International Symposium on Intensive Care & Emergency Medicine (ISICEM), therefore please understand that for organizational and security reasons a free registration for the ESA meeting is mandatory. Participation at the ESA event will not grant access to the ISICEM sessions.

A livestream will be available on the event page.

Sponsors

NB: Sponsors do not influence in any way the content of the event.

On April 25 and 26, 2023, World Sepsis Congress will return – and registrations are now open.

Over the course of two days and 16 highly-relevant and unique sessions, over 80 internationally-renowned speakers will share the newest research and insights into sepsis, pandemics, antimicrobial resistance, and – most importantly – how they are linked.

As always, the 4th WSC will be free of charge and completely virtual, enabling broad participation from all parts of the world.

Just as with the previous World Sepsis Congresses and WSC Spotlights, this free online congress brings together highly ranked representatives of international and national healthcare authorities, non-governmental organizations, policymakers, patient advocacy groups, clinical scientists, researchers, and pioneers in healthcare improvement.

The ESA Steering Committee and the ESA Secretariat jointly wish all our members and stakeholders peaceful and healthy festivities, and a great start to the new year. We look forward to our continued collaboration in 2023 to improve awareness and mitigate the burden of sepsis in Europe.

At the occasion of the last ESA Annual Meeting on 20 September, the ESA formally elected its new Steering Committee and confirmed Prof. Evangelos J. Giamarellos-Bourboulis as Chair for this new two-year term.

He commented: “While sharing my best wishes, I also congratulate my colleagues for their election, and I am honoured and humbled by their trust for serving as chair for this second term. I take it as a sign of the good work we have done together in the past three years since the first ESA Steering Committee was elected in 2019. From the inception of the ESA until now, we have tirelessly worked to make our stakeholders understand the urgency of improving sepsis management across Europe, via our advocacy initiatives, research projects, and the sharing of best practices. Looking back at 2022, I am happy to count a number of successes, culminating recently with the involvement of European Commissioner Kyriakides at the last ESA Annual Meeting, the publication of the results of the European Sepsis Care Survey and the announcement by G7 leaders, in May under the German Presidency, to commit to foster the implementation of the WHA 70.7 Resolution on sepsis. 

I look forward to keeping on working with this amazing and diverse group of colleagues who bring to the table a varied set of skills and backgrounds. I am sure that together we will achieve great results and contribute to mitigate the burden of sepsis in Europe.”

On September 28, at 9 am CEST the European Health Forum Gastein will host the session organized by ESA, in partnership with Becton Dickinson. This is the first time that sepsis is on the program of this well-known forum, which celebrates its 25th anniversary this year.

Despite being the most common cause of death from infections – including COVID-19 – sepsis is not yet sufficiently known amongst lay people and health professionals. One in five deaths worldwide is associated with sepsis.

Low awareness rates make it difficult for patients and clinicians to detect sepsis symptoms in time and respond adequately. However, sepsis can be treated relatively easily. Early recognition and cost-effective tools can save lives and minimize the socio-economic burden on health systems. Yet, still today, too many sepsis patients die or suffer long-term consequences of wrong diagnoses and therapies.

In this session, we will learn about sepsis from the patient perspective, share new data on the quality of sepsis care, and discuss its importance in infection management and AMR strategies. We will present sepsis as an indicator of the quality of care, explore best practices in sepsis management, and discuss how harmonized approaches at the EU level could save lives across Europe.

Speakers

• Gioia Babini, Integrated Diagnostic Solutions Medical Director, BD

• Kristoffer Strålin, Researcher, Karolinska Institute

• Christian Scheer, Professor, University of Greifswald

• Idelette Nutma, Patient representative, Dutch Sepsis Network (SepsisNet)

• Janet Diaz, Team Lead, World Health Organization

Moderation

• Ron Daniels, Vice-President, Global Sepsis Alliance

It is estimated that every year 680.000 people die of sepsis in Europe “This is more than the population of Luxembourg“ noted European Commissioner Kyriakides at the European Sepsis Alliance annual meeting in Brussels on 20 September. Sepsis, a deadly consequence of infections due to a dysregulated immune system reaction to them, must be treated early and with broad-spectrum antibiotics. “The nexus of AMR to sepsis is an area where we can and we must do better“ added Kyriakides, echoed later by Swedish AMR Ambassador Malin Grape. Last June, also G7 leaders stressed this link in their conclusions.

“Via existing and new processes, the European Commission and Council can facilitate the sharing of knowledge and best practices that some countries are putting in place to implement the World Health Assembly Resolution of 2017 on sepsis, that they signed up to.”, commented Prof. Evangelos Giamarellos-Bourboulis, ESA Chair, after the meeting. “Sepsis should also be integrated into the ECDC work plan, as a consequence of communicable diseases and possible outbreaks. This was already demonstrated by the pandemic: close to 80% of COVID-19 patients in ICU have sepsis, which remains the most common cause of death.”

Tereza Šauer, a sepsis survivor from the Czech Republic, almost lost her life to sepsis back in March and shared her moving story at the meeting. After the first symptoms, she was sent back home from the hospital with painkillers. Subsequently, she developed septic shock, the ultimate and lethal stage. Tereza was lucky, but diagnosis is one of the areas of sepsis management that must be improved.

Difficult diagnosis, low awareness rates, incorrect reporting of sepsis cases, and lack of surveillance of the incidence of AMR on sepsis, make it difficult to assess and monitor the real burden of sepsis.

The cause triggering sepsis is still not totally well known. Sepsis research also needs to find innovative solutions, and more funds: “Thousands of mice have been saved, not one human in the last thirty years has been saved thanks to new therapeutical approaches.”, shared Prof. Cavaillon, from the French National Research Agency.

The issue of sepsis-related costs for the health system was also discussed at the meeting. The US CDC estimated $62 billion in the overall cost of sepsis on the US health system. Equivalent European data is missing, but a recent German study calculated €15,000 as the cost of hospitalization per sepsis patient, which amounts to €9 billion in total costs to the health system. However, sepsis survivors very often need rehabilitation and continued support in the years following their hospitalization. The same German study estimates €6.8 billion as the total cost of sepsis patients’ follow-up over three years.

Funds to set up processes and implement sepsis guidelines in European hospitals are urgently needed, as demonstrated by the result of the European Sepsis Care Survey presented by Dr. Christian Scheer at the event. The long-term benefits of sepsis guidelines have not yet been fully quantified, but “what is the cost of non-action?” concluded Malin Grape.

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The 5th Annual Meeting of the ESA is just hours away, starting at 11:00h CEST on Tuesday, September 20. It’s a hybrid event – in addition to joining in person in Brussels, you can also connect via the free live stream.

The 5th Annual ESA Meeting provides a unique opportunity to hear from policymakers, experts, and patients about progress in sepsis management and integration in health systems, and open challenges requiring a united response. We are excited to confirm that Stella Kyriakides, European Commissioner for Health and Food Safety, will provide opening remarks. The physical event will be kindly hosted by the Permanent Representation of Germany to the EU, while the online live stream will be available on our website.

A COORDINATED NATIONAL ACTION PLAN TO STOP SEPSIS-RELATED PREVENTABLE DEATHS AND TO IMPROVE THE SUPPORT OF PEOPLE AFFECTED BY SEPSIS IN SWITZERLAND

Sepsis is when our body’s response to infection causes a shutdown of vital organs. It is a devastating disease responsible for over 10 million deaths worldwide every year. In Switzerland, studies have estimated that sepsis affects about 20,000 people and causes almost 3,500 deaths every year. Up to half of those who survive will suffer long-term, sometimes life-long, adverse consequences of sepsis. Sepsis can affect people of any age and health condition. The most vulnerable groups are newborns and young infants, the elderly, and people with chronic health conditions or reduced immune defenses.

In 2017, the World Health Organization (WHO) declared sepsis a global health priority. The 2021 European Sepsis Report revealed that – contrary to other European countries – Switzerland had not yet actioned the sepsis resolution. In response, a group of over 50 sepsis experts (including clinical, academic, and policy professionals, and sepsis survivors) reviewed the needs, gaps, and strategies to address sepsis in Switzerland.

The expert panel identified sepsis as a key priority that requires a coordinated national approach and formulated a Swiss Sepsis National Action Plan (SSNAP). The four key recommendations include:

1. Raising awareness of sepsis in the public as well as improving sepsis-specific education in the healthcare workforce, and improving prevention of sepsis.

2. Establishing and implementing standards for rapid detection, treatment, and follow-up in sepsis patients.

3. Creating support systems for sepsis survivors.

4. Promoting research on sepsis.

The panel encouraged realistic strategies, fitting to the Swiss context, which is guided by evidence. Specifically, Switzerland should learn from successful sepsis programs in other countries, while using the local expertise, networks, and culture to meet the needs of the Swiss population. The Swiss Sepsis National Action Plan lists specific recommendations which should result in improved patient-centered care in Switzerland. The implementation of these recommendations is expected to save lives, reduce the long-term burden of sepsis on families, and reduce costs for the Swiss health care system.

The SSNAP has been endorsed by the following Swiss professional societies:

• Interest Group Pediatric and Neonatal Intensive Care (IGPNI) Switzerland

• Pediatric Infectious Disease Group of Switzerland (PIGS)

• Public Health Swiss

• Swiss Institute for Medical Education and Training (SIWF)

• Swiss Patient Safety Foundation

• Swiss Society for Infectious Diseases (SGINF)

• Swiss Society of Emergency and Rescue Medicine (SGNOR)

• Swiss Society of General Internal Medicine (SSGIM)

• Swiss Society of Intensive Care Medicine (SSICM)

• Swiss Society of Microbiology (SGM-SSM)

• Swiss Society of Neonatology

• Swiss Society of Pediatrics (SGP)

Today is World Sepsis Day – countless events in all parts of the world are raising awareness for sepsis today.

In addition to joining local WSD Events, we have collected some last-minute activities on the World Sepsis Day website…

Tereza Šauer was a sporty and healthy person when at the beginning of 2022 she had a septic shock caused by a campylobacter. She luckily survived, but she is still suffering from post-sepsis syndrome. She had never thought she could get sepsis from simply handling raw chicken. Tereza is now committed to raise awareness about sepsis in the Czech Republic. She will share her story, and we will talk about sepsis patients’ challenges and expectations at the ESA Annual Meeting on 20 September, in Brussels and online. Register for the event via the button, and read Tereza’s story below.

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It all started in Bali, where I lived at the time. After a year, I planned to visit my parents and friends in the Czech Republic. About a month before I left, I contracted Covid-19 (Omicron variant), which knocked my immunity to zero. My immunity used to be so strong. Colds or viruses had been foreign words to me for several years. About 5 days before my flight, I was preparing chicken for a broth and had a nostril on my fingernail. It wasn't the first time I'd come in contact with raw chicken, so it never occurred to me that the gut was the gateway to Campylobacter infection. On the day of my arrival in the Czech Republic, everything was still fine, I didn't feel anything, I just found it weird that I didn't have a taste for beer, it always means something is wrong. This time I attributed it to fatigue after a long journey…

The next day, fevers and chills began. I thought it was post-covid syndrome. I lasted another day, but the temperature began to mysteriously fluctuate from 39.5 to 34.3. It seemed absurd to me and led to a broken thermometer. That Wednesday in the evening, I fell unconscious. My parents called the ambulance, which took me to the hospital. After a few hours, they told me the results showed an intestinal virus and I could go home. It was 2 o'clock in the morning. They recommended another blood sample in 2 days.

That Friday, I wasn’t able to stay on my feet anymore, I couldn't talk, and I had horrible stomach aches, and terrible green diarrhea so the nurse came to take my blood sample at home. An hour later, when she got the blood results, she sent an ambulance to me, saying that I was in danger of death. CRP level 430, pressure 70/40, malaise, dehydration – I had developed sepsis, which began to turn into septic shock. My kidneys were starting to fail. After a few hours on admission, when I underwent various examinations (X-ray and CT of the abdomen, blood samples, etc.), they took me to the intensive care unit. They knew it was a septic shock. They immediately inserted a probe that drained 1.5 liters of green infectious fluid from my stomach, which had formed there for a week. After a few days, the antibiotics stopped working and the inflammatory values jumped up again. It showed another source of infection in my body. My heart was starting to fail, and I had water in my lungs.

It was the morning of March 3 when they told me that I needed emergency surgery to look into my stomach. It's the day I'm going to celebrate my second birthday. I had a 10% chance of surviving. They inserted central venous access into my throat, from where they took my blood daily and infused me because my veins were terribly weak and were already starting to rupture. The abdomen and intestines were full of infectious fluid, which caused inflammation of the peritoneum, a dysfunctional intestine on which adhesions formed. The infection was so great that it hit my lungs.

I was relieved after this operation, even though I was weak and wasn’t able to stay on my feet. I was finally able to drink after a week. I spent another week in the ICU's surgical department, where they slowly began to teach me to stand on my own two feet and take at least a few steps with the help of a walker. These were the worst moments – I had been in shape all the time, as a coach I put into my body as much as I could, how many times I disobeyed my body, and when it couldn't, I loaded him twice as much. Hard training, extreme mountain hikes, untreated injuries, because I still have to train, etc. and suddenly I can't stay on my own feet?!

Evidently, my body brought me back to the years of torturing and driving him to extremes without being grateful to him for all that. I was still dissatisfied, well, here I have it, I can and I have to start all over again. I left the hospital like a skeleton, my dad had to take me up the stairs – my legs didn't carry me at all.

By the time this is published, it will be 2 months since I am home from the hospital. It's still very difficult, and I have post-sepsis syndrome. For me, it's a change in taste, problems with short-term memory, my hair falling out a handful, I have nightmares at night, panic about the possibility of another infection, problems with appetite, mood swings, mental problems, and fatigue.

Every day, I write down my progress. I don't bother my body and I'm infinitely grateful to him for winning a second chance at life for me! And I'm grateful to my great parents, whom I have exposed to terrifying moments. How they support me and take care of me in this difficult time is beyond explanation. I am writing this story to raise awareness of this insidious disease, where time and awareness play a critical role for one to survive. Very few people in the Czech Republic know about sepsis.

Now I have problems with my stomach and intestines. I am still on a very strict diet, unfortunately, and I still can't eat what I was used to before – piles of vegetable salads, spicy food, and much more. And in a month, I will have my first session with a psychologist due to a post-traumatic stress disorder I was diagnosed with.

I try to practice yoga 2-3 times a week, and I go for walks regularly – I am up to 9 km now after I started with 50 meters after being released from the hospital.

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The ESA Annual Meeting is returning on 20 September 2022 in a hybrid format, in person in Brussels and online. It will provide a unique opportunity to hear from policymakers, experts, and patients about progress in sepsis management and integration in health systems, and open challenges requiring a united response. We are excited to confirm that Stella Kyriakides, European Commissioner for Health and Food Safety, will provide opening remarks. The physical event will be kindly hosted by the Permanent Representation of Germany to the EU, while the online live stream will be available on our website. Registrations are now open.

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SEPSIS MANAGEMENT, AN INDICATOR OF QUALITY OF CARE IN EUROPE

In January 2020, anticipating the outburst of the Sars-Cov-2 pandemic, the most updated data on sepsis were revealed, confirming what experts already suspected: sepsis is the most common cause of death worldwide, one every five, claiming 11 million lives globally every year. The pandemic has also demonstrated that sepsis is the main cause of death amongst COVID-19 patients, affecting almost 80% of those hospitalized in ICU. Furthermore, the similarities between the long-COVID and post-sepsis syndromes are stunning.

Antimicrobial resistance – often called “the silent pandemic” – hampers infection management and facilitates the occurrence of sepsis. Recent data from Sweden confirm the correlation.

Pandemic preparedness, infection management, or AMR strategies cannot prescind from efficient sepsis management. In fact, these are all aspects that comprehensive infection management strategies must include.

What if sepsis quality of care became a key indicator for the performance assessment of health systems? Reduced harm from sepsis means that health systems can prevent, identify and manage infections, and use antimicrobials effectively. However, how can we manage sepsis if we do not collect data systematically in Europe? What can we learn from those countries that have started implementing strategic measures in integrating sepsis in their national health systems?

These are some of the questions that we will try to answer at the 5th ESA annual meeting, with high-level speakers from institutions, experts, and patients.

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On September 16, 2022, the Global Sepsis Alliance and the Sepsis Stiftung will join forces to host a unique event celebrating a decade of World Sepsis Day – both in person in Berlin, as well as live streamed on the event website.

Following a scientific symposium with renowned speakers from all over the world and an international best-practices panel, we will celebrate the achievements of the past 10 years, present the Global Sepsis Awards, and conclude this unique World Sepsis Day event with a fundraising dinner, featuring international artists who share our commitment to the vision of “A World Free of Sepsis”.

We are excited to welcome you to Berlin in person in September or see you on the free live stream for the symposium and the best-practices panel.

Five years after the adoption of the Resolution “Improving the Prevention, Diagnosis and Clinical Management of Sepsis” by the World Health Assembly in 2017, G7 Health Ministers commit to intensify efforts to strengthen early detection, diagnosis, and therapy of sepsis in their joint conclusion.

“We commend Germany’s leadership and particularly Minister Lauterbach, who understands the importance of addressing sepsis awareness, diagnosis, and management in Germany by supporting a national campaign, and bringing it to the agenda of G7. Five years after the adoption of Resolution 70.7, its implementation is still lagging behind. The G7 countries are leaders in sepsis management, and we hope that their example inspires other countries around the world in setting up national strategies encompassing awareness, education, diagnosis, treatment, and support to sepsis patients after hospital dismissals.”

— Prof. Niranjan ‘Tex’ Kissoon, GSA President

Successful sepsis treatment is affected by antimicrobial resistance. The G7 health ministers’ conclusions remind us that ineffective or unavailable antibiotic treatments contribute to the 11 million deaths caused by sepsis annually. The G7 also commits to allocating resources to support low- and middle-income countries and to strengthen prevention through capacity-building where appropriate.

The European Sepsis Alliance, the Global Sepsis Alliance, and the other Regional Sepsis Alliances are working with national governments and all relevant stakeholders to foster the implementation of the 70.7 resolution. Besides the G7, other European countries are setting up national sepsis strategies integrating sepsis management in their national health systems, backed by Australia.

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About Sepsis

Sepsis is the common final pathway of all acute infections. It arises when the body’s response to an infection injures its own tissues and organs. It may lead to shock, multiple organ failure, and death, especially if not recognized early and treated promptly.

Saving civilian life must be a top priority, healthcare workers must be protected, health systems and facilities need to remain functional, safe, and accessible

The European Sepsis Alliance joins the call for peace in Ukraine, echoing calls by so many organizations and individuals around the world. We encourage our members and supporters to do whatever they can to help Ukrainian civilians and the Ukrainian healthcare system. 

War always causes a humanitarian and health emergency affecting civilians. Children, women, and the elderly are the most exposed to the risks linked to the disruption of safe healthcare and access to medicines. Displacement of swathes of the population from their homes (some with injuries or with underlying health conditions), the mass movement of people, crowding, loss of sanitation and loss of access to both preventative medicine and healthcare services increases the risk of infections and resultant sepsis in an environment which might lack the capacity to treat it – people with pre-existing conditions who are most at risk from infections and sepsis will likely not get the treatments they need. Already we hear that supplies of oxygen in Ukraine’s hospitals are critically low.

 A functioning healthcare system is a basic human right that must be protected, along with the safety and security of healthcare workers and facilities.

Many organizations (see the list below) are providing active support to the Ukrainian population. We encourage you and our members to support these organizations in the same manner as you support the European Sepsis Alliance and the Global Sepsis Alliance.

Additionally, the Ukrainian Ministry of Health is inviting foreign healthcare professionals to go and work in local hospitals. More details are available here.

This new crisis comes as the Covid-19 pandemic, which has already put all healthcare systems under pressure, continues. Ukrainian hospitals, doctors, nurses, civilians, and refugees desperately need our help.

List of organizations providing support:

• International Committee of the Red Cross

• Médecins Sans Frontières

• Save the Children

• UNICEF