Current aspects of the definition and diagnosis of sepsis and antibiotic resistance

Hospital mortality of patients with secondary sepsis remains high at around 40%. Because of the methodological deficiencies of the definitions used so far, valid epidemiological data on secondary sepsis that allow for national and international comparisons are lacking. Since 2016, new clinical diagnostic tools that are also suitable for sepsis screening outside of intensive care units have been available. To counteract the high mortality of nosocomial sepsis, new approaches to the early identification of at-risk patients are needed. An adequate blood culture sampling rate and a high preanalytical quality should be established as a basis for quality assurance, especially in the field of nosocomial bloodstream infections; otherwise, there is a risk of surveillance bias. Data from laboratory-based antibiotic resistance surveillance on MRSA in blood culture isolates have shown a downward trend over the last 4 years. In Gram-negative pathogens, a relatively stable resistance situation has been observed over this period for many of the pathogen-antibiotic combinations.