The aetiology, pathogenesis, diagnosis and
therapy of
sepsis are dealt with in this paper. These problems are discussed on the basis of 151 patients treated for
sepsis. The cases with monoinfection are 73.6% and those with polyinfection are 24.4%. Monoinfection is caused mainly by Staphylococci -65,3%, followed by E. coli - 15.2%, Proteus - 13% and Klebsiella - 3.3%. For the cases of polyinfection the gram-negative bacteria are 3:1 in respect to the gram-positive bacteria. The bacteriological finding from the haemoculture (92.8% mono- and 7.2% polyinfection) is not equal to this from the input source. Here also the cases of monoinfection are mainly caused by Staphylococci - 70.9%, followed by Proteus - 7.7%, E. coli - 6%, Klebsiella aerogenes - 5.1% and Streptococcus 2.6%. The gram-negative bacteria prevail in the cases of polyinfection. The virulent aggressive
infection, bacteria resistant to
antibiotics, the aggressive local
infection,
hypoproteinemia, anaemia, diabetes, a prolonged
corticosteroid treatment and unsuitable
antibiotic treatment are discussed as main factors predisposing to
sepsis. All the 151 patients were treated with the complex
therapy, recommended in this paper. It includes a surgical cleaning-up of the initial nidus, intensive reasonable
antibiotic treatment against the gram-positive and gram-negative aerobes and anaerobes. Additionally, substitution of infusion
therapy,
parenteral nutrition, regulation of the pathophysiological deviations and stimulating
therapy are carried out. 74.2% from the patients were cured, 25.8% died. 16.6% of the patients who died had
sepsis caused by gram-positive bacteria, and 46.1% had
sepsis caused by gram-negative bacteria. 17% of the patients who died had septicaemia and 22% had septicopyaemia.(ABSTRACT TRUNCATED AT 250 WORDS)