Allen Victoria B, Bechman Katie, Russell Mark D, Adas Maryam A, Goodman Anna L, McPhail Mark J, Norton Sam, Galloway James B
Centre for Rheumatic Diseases, King's College London, London, UK.
Department of Infection, King's College London, London, UK.
Infection. 2025 Jul 15. doi: 10.1007/s15010-025-02601-0.
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. It is a major cause of morbidity and mortality. A contemporary overview of sepsis epidemiology in England is long overdue. This study provides an update on the incidence of sepsis-coded hospital admissions and mortality following the COVID-19 pandemic, focusing on the relative contribution of different bacterial pathogens to sepsis-coded admissions.
We undertook a descriptive study of all hospital admissions from April 1998 to March 2024 using routinely collected health data. Information on sepsis admission episodes, causative pathogens, age, sex, length-of-stay and mortality were collected.
Sepsis-coded hospital admissions increased from 27.9 admissions per 100,000 in 1998 to 210.4 in 2023, a 7.5-fold increase. The incidence of sepsis-coded admissions due to most pre-specified pathogens of interest increased. The largest increases were seen for sepsis due to Enterococci, Streptococcus pyogenes, gram-negative bacteria, Streptococcus agalactiae, Staphylococcus aureus and Listeria spp. Sepsis due to meningococcus decreased. The percentage of patients aged ≥ 75 years admitted with sepsis increased from 32.4 to 52.5% of sepsis cases. Median length-of-stay was 6.1 days. Sepsis-coded admissions and mortality decreased during the COVID-19 pandemic. These have now returned to pre-pandemic levels.
The recorded incidence of sepsis-coded hospital admissions has risen. This may have been impacted by coding changes and improved disease recognition. The decrease in meningococcal sepsis may reflect the success of vaccination campaigns. Further research is needed to explore concurrent trends in sepsis severity, predict who is at greatest risk and improve prevention efforts.
脓毒症是由宿主对感染的失调反应引起的危及生命的器官功能障碍。它是发病和死亡的主要原因。早就应该对英国脓毒症流行病学进行当代概述了。本研究提供了关于新冠疫情后脓毒症编码的住院率和死亡率的最新情况，重点关注不同细菌病原体对脓毒症编码住院的相对贡献。
我们使用常规收集的健康数据对1998年4月至2024年3月期间的所有住院患者进行了描述性研究。收集了关于脓毒症住院病例、致病病原体、年龄、性别、住院时间和死亡率的信息。
脓毒症编码的住院率从1998年的每10万人27.9例增加到2023年的210.4例，增长了7.5倍。大多数预先指定的相关病原体导致的脓毒症编码住院率有所上升。粪肠球菌、化脓性链球菌、革兰氏阴性菌、无乳链球菌、金黄色葡萄球菌和李斯特菌属导致的脓毒症增长幅度最大。脑膜炎球菌导致的脓毒症有所下降。≥75岁脓毒症住院患者的比例从脓毒症病例的32.4%增加到52.5%。中位住院时间为6.1天。新冠疫情期间，脓毒症编码的住院率和死亡率有所下降。目前这些指标已恢复到疫情前的水平。
记录的脓毒症编码住院率有所上升。这可能受到编码变化和疾病识别改善的影响。脑膜炎球菌性脓毒症的下降可能反映了疫苗接种运动的成功。需要进一步研究脓毒症严重程度的并发趋势，预测谁的风险最大，并改进预防措施。
