Gram-negative sepsis is a potentially life-threatening condition caused by Gram-negative bacterial infection. It can lead to septic shock and affect organ function. Early diagnosis and treatment with antimicrobial therapy, intravenous fluids, and other measures are important to reduce the risk of septic shock. Patients with low immunity, traumatic injuries, or who have used broad-spectrum antibiotics are at increased risk.
Sepsis is a medical condition in which the entire body experiences inflammation as it tries to fight off an infection that has made its way into the bloodstream. Gram-negative sepsis is the result of a Gram-negative bacterial infection. It is a potentially life-threatening condition that most commonly affects young children and the elderly.
Gram-negative bacteria get their name from their appearance after a staining procedure under a microscope. Bacteria that don’t react to a stain called crystal violet are considered Gram-negative. That lack of staining reaction indicates the type of membrane the organisms possess.
Gram-negative bacteria have a cell membrane that contains lipopolysaccharide, which the body rejects as part of an immune reaction. This produces an inflammatory response as the body’s cells react to fight infection. Sepsis occurs when these immune cells become overactivated, causing a widespread body response.
Gram-negative sepsis produces a change in temperature as the body tries to compensate, and patients may have fever or hypothermia. This can cause shivering, an increased heart rate, and a faster breathing rate. Lab changes show high or low numbers of white blood cells, the cells that help the body fight infection. Sepsis can eventually begin to affect organ function, causing symptoms of mental confusion or impaired kidney function.
Sepsis can lead to septic shock, which often causes death. As the symptoms of sepsis affect the organs, overall blood pressure may decrease, requiring extra intravenous fluids to maintain perfusion. During septic shock, the body may not respond to the extra fluids, resulting in the heart’s inability to deliver adequate amounts of oxygenated blood to the tissues.
Gram-negative sepsis can be treated with antimicrobial therapy to help fight the bacteria causing the infection. Early diagnosis and treatment are important to reduce the risk of septic shock. Doctors often diagnose the infection through a blood culture, in which a blood sample is monitored in the laboratory for the growth of microorganisms. Blood cultures can take up to 72 hours to produce results, so antibiotic treatment can be started during the time it takes to specifically identify the Gram-negative organism. Some types of Gram-negative bacteria that can cause infections and sepsis include Escherichia coli (E. coli), Klebsiella, and Pseudomonas aeruginosa.
In addition to antimicrobial therapy and intravenous fluids, other measures may be needed to treat Gram-negative sepsis. Medications to raise blood pressure are warranted if a patient does not respond to increased fluids. Some types of steroids can also be used to reduce inflammation. If a patient develops breathing difficulties due to reduced lung function, the use of a ventilator may be required. A combination of therapies is often needed to reduce the harmful effects.
People who have certain conditions are at increased risk of developing Gram-negative sepsis, including those who have low levels of immunity and those with traumatic injuries such as burns. Patients who have used large amounts of broad-spectrum antibiotics to treat other infections may be prone to developing sepsis. Also, age is a factor, and sepsis most commonly affects children and the very old.
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