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Medicina
Special Issues
Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies
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Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 5175

Special Issue Editor

Dr. Alice Dragoescu

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: sepsis; septic shock; prognosis; presepsin; neutrophil to lymphocyte ratio (NLR); agenesis of ductus venosus; portal venous system anomalies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sepsis, a life-threatening condition resulting from a dysregulated host response to infection, has been a significant global health concern for decades. Despite advances in medicine, sepsis continues to cause substantial morbidity and mortality worldwide, particularly in low- and middle-income countries. The condition has complex etiologies, making it difficult to diagnose and treat, especially in resource-limited settings. Historical milestones in understanding sepsis include the early recognition of its systemic inflammatory nature and the development of protocols such as the "Surviving Sepsis Campaign." However, the increasing prevalence of antimicrobial resistance and disparities in healthcare delivery have added new dimensions to this age-old challenge, necessitating renewed focus and collaborative global strategies.

This Special Issue, Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies, will provide a comprehensive platform for discussing the latest developments in sepsis research, prevention, and management. By integrating insights from epidemiological studies, clinical advancements, and public health efforts, this Special Issue will address global disparities in sepsis outcomes and resource allocation. It emphasizes the importance of innovative diagnostic tools, effective treatment protocols, and global awareness campaigns for reducing the burden of sepsis. This Special Issue will serve as a multidisciplinary forum for advancing understanding, fostering collaboration, and shaping policies to improve sepsis care globally.

This Special Issue will feature cutting-edge research that explores novel approaches to diagnosing, treating, and managing sepsis. Topics of interest include the following:

  • Development and implementation of biomarkers and rapid diagnostic tools;
  • Artificial intelligence and machine learning applications in sepsis prediction and management;
  • Innovations in antimicrobial therapies and strategies to combat resistance;
  • Insights into the immunopathology and molecular mechanisms of sepsis;
  • Advances in personalized medicine, such as precision therapeutics tailored to individual patient profiles;
  • Global epidemiological trends, highlighting disparities in incidence, outcomes, and resource availability;
  • Evaluation of awareness campaigns and their impacts on early detection and treatment;
  • Health systems approaches for improving sepsis care in low-resource settings.

We invite original research articles, reviews, meta-analyses, clinical case studies, and commentaries that align with the following themes:

  • Epidemiological studies examining the global and regional burden of sepsis;
  • Research on diagnostic innovations, including biomarkers and imaging techniques;
  • Studies on treatment protocols, including the use of advanced therapies and supportive care;
  • Investigations into the role of antimicrobial resistance in sepsis outcomes;
  • Papers highlighting the challenges and successes of awareness campaigns;
  • Research on healthcare disparities and access to sepsis care in different regions;
  • Contributions on public health policies and interventions for improving sepsis outcomes;
  • Translational research bridging basic science findings with clinical applications;
  • Perspectives on sepsis management in specialized populations, such as neonates, the elderly, and immunocompromised patients.

Dr. Alice Dragoescu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis
  • global health
  • treatment strategies
  • early diagnosis
  • personalized medicine
  • immunopathology
  • awareness campaigns

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Published Papers (3 papers)

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Research

19 pages, 2404 KiB  
Article
Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
by Florentina Mușat, Dan Nicolae Păduraru, Alexandra Bolocan, Cosmin-Alexandru Palcău, Andrei-Alexandru Bunea, Daniel Ion and Octavian Andronic
Medicina 2025, 61(5), 864; https://doi.org/10.3390/medicina61050864 - 8 May 2025
Viewed by 548
Abstract
Background and Objectives: Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by reporting [...] Read more.
Background and Objectives: Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by reporting recent data from one of the largest emergency centers in Romania over an 18-year period (2007–2024). Materials and Methods: A retrospective analysis was conducted on 12,089 adult patients diagnosed with sepsis at the University Emergency Hospital of Bucharest. Patients were identified using International Classification of Diseases (ICD-10) codes and free-text diagnosis. Demographic and clinical data were extracted, including comorbidities, interventions, and mortality outcomes. Associations between comorbidities and in-hospital mortality were assessed using odds ratios (ORs) and 95% confidence intervals (CIs). Results: The study population had a mean age of 68.7 years, with a slight predominance of males (50.9%). In-hospital mortality was 53.9%, and 30-day mortality reached 85.1%. The most common comorbidities were diabetes (27.2%), chronic kidney disease (14.0%), and cancer (12.9%). Pneumonia (OR = 2.08, 95% CI: 1.89–2.28), cirrhosis (OR = 1.69, 95% CI: 1.40–2.03), and chronic obstructive pulmonary disease (OR = 1.50, 95% CI: 1.27–1.77) were strong predictors of mortality, while diabetes was associated with a slightly lower risk (OR = 0.90, 95% CI: 0.83–0.97). Conclusions: Sepsis-related mortality in Romania is higher than reported in Western Europe and North America, resembling trends in resource-limited settings. Targeted early recognition, antimicrobial stewardship, and improved intensive care units (ICU) resource allocation are crucial for reducing mortality. Multicenter studies and microbiological analyses are needed to further understand sepsis outcomes in this region. Full article
(This article belongs to the Special Issue Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies)
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14 pages, 1642 KiB  
Article
An Epidemiological Survey of Sepsis in a Tertiary Academic Hospital from Southwestern Romania
by Andra Grigorescu, Florentina Dumitrescu, Stefania Dorobantu, Adina Dragos, Andrei Pirvu, Mihaela Roskanovic, on behalf of the FUSE study, Ioana Streata, Mihai Ioana, Mihai G. Netea and Anca-Lelia Riza
Medicina 2025, 61(4), 596; https://doi.org/10.3390/medicina61040596 - 26 Mar 2025
Viewed by 548
Abstract
Background and Objectives: Sepsis is one of the major causes of death in modern society. This study is part of the FUSE (Functional Genomics in Severe Sepsis) project under the Human Functional Genomics Romania initiative. Our aim was to assess the epidemiology [...] Read more.
Background and Objectives: Sepsis is one of the major causes of death in modern society. This study is part of the FUSE (Functional Genomics in Severe Sepsis) project under the Human Functional Genomics Romania initiative. Our aim was to assess the epidemiology of sepsis in a tertiary academic hospital in southwestern Romania. Materials and methods: The study enrolled 184 patients with severe infections between May 2017 and November 2019, following the Sepsis-2 guidelines (SIRS criteria). Results: The present cohort of community-acquired severe infections shows respiratory and urinary tract as main sites of severe infection. The demographic and clinical characteristics of this Romanian study group are in line with those of other severe infection European cohorts. However, the predominance of confirmed Clostridium difficile cases represents a strong deviation, raising significant concerns for the communities to which the patients belong. Conclusions: Sepsis, with its complex pathophysiology and clinical presentation, remains one of the most daunting global health issues. In our cohort, the high number of Clostridium difficile cases prompts high vigilance and immediate intervention. Full article
(This article belongs to the Special Issue Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies)
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17 pages, 5269 KiB  
Article
Endogenous IL-7 Variation in Relation to Lymphocyte Subtypes in Septic Patients
by Raluca-Ștefania Fodor, Alice Drăgoescu, Oana Coman, Adina Huțanu, Anca Bacârea and Bianca-Liana Grigorescu
Medicina 2025, 61(2), 258; https://doi.org/10.3390/medicina61020258 - 2 Feb 2025
Viewed by 1081
Abstract
Background and Objectives: Sepsis triggers a complex immune response, disrupting the balance between pro- and anti-inflammatory signals and causing widespread immune cell apoptosis. Interleukin 7 (IL-7) is emerging as one of the most promising immunoadjuvants to boost host immunity during the immunosuppressive [...] Read more.
Background and Objectives: Sepsis triggers a complex immune response, disrupting the balance between pro- and anti-inflammatory signals and causing widespread immune cell apoptosis. Interleukin 7 (IL-7) is emerging as one of the most promising immunoadjuvants to boost host immunity during the immunosuppressive phase of the disorder. This study aimed to investigate the dynamics of endogenous plasma levels of IL-7 during sepsis and septic shock, correlating its levels with lymphopenia and various lymphocyte subtypes, including CD4+ and CD8+ T cells, B cells, and natural killer T cells (NKT), in both survivors and non-survivors. Materials and Methods: This prospective observational study included 87 critically ill patients. We categorized the patients into four subgroups based on their diagnosis (sepsis or septic shock) and survival status (survivors and non-survivors). The parameters were monitored on day 1 (when sepsis was diagnosed according to the Sepsis-3 Consensus) and again on day 5. Eighty-two healthy volunteers were included as a control group to establish the cut-off values for IL-7. Results: Statistical analysis revealed a significant difference in median values between days 1 and 5 for lymphocytes (p = 0.01) and NKT cells (p = 0.01), observed only in sepsis survivors. In the group of sepsis survivors, we observed a negative correlation between IL-7 levels and NKT cells but only on day 1. Additionally, we identified negative correlations between Th cells (CD4+) and Tc cells (CD8+) on both day 1 and day 5. In the group of sepsis non-survivors, we observed a positive correlation between IL-7 and B cells (CD19+) but only on day 1. We also identified a negative correlation between Th cells (CD4+) and Tc cells (CD8+) on day 1. In the group of septic shock survivors, we did not observe any correlation between IL-7 levels and other parameters studied on day 1 or day 5. We identified a negative correlation between Th cells (CD4+) and Tc cells (CD8+) on both day 1 and day 5, a negative correlation between Th cells (CD4+) and NKT cells on both day 1 and day 5, and a positive correlation between Th cells (CD4+) and B cells (CD19+) on day 1. In the group of septic shock non-survivors, we did not observe any correlation between IL-7 and other parameters studied. Conclusions: Determining the IL-7 plasmatic value every five days did not demonstrate the necessary sensitivity and specificity as a biomarker to accurately assess each patient’s immune balance. Endogenous IL-7 levels appear inadequate to overcome the immunosuppressive environment induced by sepsis. Full article
(This article belongs to the Special Issue Global Perspectives on Sepsis: Epidemiology, Awareness and Treatment Strategies)
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