Alarming Link Between Lengthy Hospital Stay and Later Risk of Sepsis
New research has uncovered a disturbing link between lengthy hospital stays and the risk of developing subsequent sepsis. Sepsis is a catastrophic immune system reaction to infection that floods the body with toxins and often leads to rapid decline and even death. The research concludes that older adults who have recently been dismissed after a hospital stay are three times more likely to develop sepsis within the following three months. The risk is even higher if they were treated for any infection—especially the increasingly common gut infection called Clostridium difficile (C. diff).
C. diff is a disease-causing microbe that often takes hold in the digestive tracts of older people who have been hospitalized or otherwise institutionalized, and given multiple courses of antibiotics to treat various types of infection. The antibiotics appear to kill off good and bad bacteria alike in the gut, making room for C. diff to move in and take over. Once established, it can be devilishly difficult to eradicate. C. diff infection causes terrible, chronic diarrhea, is highly infectious, and can eventually cause severe illness or even death in extreme cases.
Among people who where treated for hospital-acquired C. diff infection, the risk of subsequent sepsis after dismissal from the hospital jumped to a startling 70%. One-in-ten C. diff. patients succumbed to sepsis within three months of dismissal, according to the new study, published in the American Journal of Critical Care and Respiratory Medicine.
My readers will probably recognize that this is another story related the the health of the gut microbiome—the diverse collection of communities of (ideally) friendly bacteria living in the digestive tract. Lengthy hospital stays—and especially, antibiotic use—are linked to severe disruptions in the gut microbiome. “Our findings could mean that disruption to the microbiome in the hospital may predispose older people to get sepsis later, which is different from what we already know about the acute and chronic effects of microbiome disruption," said lead author Hallie Prescott, M.D., M.Sc. "While more work is needed to explore this further, it also opens the possibility that we might be able to prevent sepsis—by doing something as simple as helping the microbiome recover rapidly from a hospitalization.”
Frankly, I’m surprised it’s taken this long to figure that out. It has been apparent to anyone who pays attention (my faithful readers?) that one messes with the gut microbiome at one’s peril. I’ve written extensively about the importance of a healthy gut microbiome, and the impact antibiotics can have on it. I’ve also mentioned, repeatedly, that it’s crucial to maintain your gut microbiome health by eating plenty of high-fiber whole foods, and I’ve recommended yogurt and other fermented foods to help keep the gut colonized with beneficial bacteria.
Scientists finally seem ready to recognize the undeniable evidence of this important link. “The implications of this paper are big," said Theodore J. Iwashyna, M.D, PhD., senior author of the study, in a press release. “We know that a major cause of microbiome disruption is antibiotic use. This study hints—it does not prove, but it hints—that profligate use of antibiotics might not just be bad because of antibiotic resistance. Profligate use of antibiotics might also, via the microbiome, put patients at increased risk of both all kinds of other infections, and to having a particularly bad response ('sepsis') to those infections."
Hallie C Prescott, Robert P. Dickson, Mary A.M. Rogers, Kenneth M Langa, Theodore J Iwashyna. Hospitalization Type Predicts Risk of Subsequent Severe Sepsis. American Journal of Respiratory and Critical Care Medicine, 2015; 150527130409004 DOI: 10.1164/rccm.201503-0483OC