Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–10.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–88.

Adhikari NK, Fowler RA, Bhagwanjee S, Rubenfeld GD. Critical care and the global burden of critical illness in adults. Lancet. 2010;376(9749):1339–46.

Article  PubMed  PubMed Central  Google Scholar 

Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259–72.

Rudd KE, Johnson SC, Agesa KM, Shackelford BA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200–11 <b>This study demonstrates the significance of sepsis on a global scale, as it accounts for almost 20% of global deaths. The incidence of sepsis varied according to different geographical areas, with the highest burden in Sub-Saharan Africa, Oceania, and areas of Southeast Asia.</b>undefined.

Article  Google Scholar 

Shankar-Hari M, Harrison DA, Rubenfeld GD, Rowan K. Epidemiology of sepsis and septic shock in critical care units: comparison between sepsis-2 and sepsis-3 populations using a national critical care database. Br J Anaesth. 2017;119(4):626–36.

Article  CAS  PubMed  Google Scholar 

The Sepsis Manual. 6th ed. Daniels R, Nutbeam T (eds). United Kingdom Sepsis Trust. 2022.

Key statistics from the Case Mix Programme - adult, general critical care units 1 April 2019 to 31 March 2020. London, UK: Intensive Care National Audit and Research Centre. 2020.

Burki TK. Sharp rise in sepsis deaths in the UK. Lancet Respir Med. 2018;6(11):826.

Article  PubMed  Google Scholar 

Sepsis: recognition, diagnosis and early management. London: National Institute for Health and Care Excellence (NICE); 2017 Sep 13. PMID: 32011837. Available from: https://www.nice.org.uk/guidance/ng51.

Li L, Sunderland N, Rathnayake K, Westbrook J. Epidemiology of sepsis in Australian public hospitals. Sydney: ACSQHC; 2020.

Google Scholar 

Burrell AR, McLaws ML, Fullick M, Sullivan RB, Sindhusake D. SEPSIS KILLS: early intervention saves lives. Med J Aust. 2016;204(2):73.

Article  PubMed  Google Scholar 

Sykes K, Thursky K, Travis D, Cheng A, George C, POwer R, et al. Think sepsis. Act fast. Scaling collaboration program evaluation report. Melbourne: Safer Care Victoria. 2020.

Secombe PJ, Brown A, Bailey MJ, Huckson S, Chavan S, Litton E, et al. Twelve-month mortality outcomes for Indigenous and non-Indigenous people admitted to intensive care units in Australia: a registry-based data linkage study. Med J Aust. 2023;218(2):77–83.

Article  PubMed  Google Scholar 

Wise R, de Vasconcellos K, Skinner D, Rodseth R, Gopalan D, Muckart D, et al. Outcomes 30 days after ICU admission: the 30DOS study. Southern African Journal of Anaesthesia and Analgesia. 2017;23(6):139–44.

Article  Google Scholar 

Green S, Kong VY, Clarke DL, Sartorius B, Odendaal J, Bruce JL, et al. The spectrum and outcome of surgical sepsis in Pietermaritzburg. South Africa S Afr Med J. 2017;107(2):134–6.

Article  CAS  PubMed  Google Scholar 

Paul R, Neuman MI, Monuteaux MC, Melendez E. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics. 2012;130(2):e273–80.

Article  PubMed  Google Scholar 

Kahn JM, Davis BS, Yabes JG, Chang CH, Chong DH, Hershey TB, et al. Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis. JAMA. 2019;322(3):240–50.

Article  PubMed  PubMed Central  Google Scholar 

• Venkatesh B, Schlapbach L, Mason D, Wilks K, Seaton R, Lister P, et al. Impact of 1-hour and 3-hour sepsis time bundles on patient outcomes and antimicrobial use: a before and after cohort study. Lancet Reg Health West Pac. 2022;18: 100305. The study investigated the implementation of sepsis bundles for patients presenting to the emergency unit. The successful implementation of 1-hour and 3-hour sepsis bundles resulted in less need for ICU admission, and improved bundle compliance. Post-intervention analysis showed a reduction in in-hospital mortality. This study shows the value of appropriate sepsis bundles.

Article  PubMed  Google Scholar 

Harrison DA, Welch CA, Eddleston JM. The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care. 2006;10(2):R42.

Article  PubMed  PubMed Central  Google Scholar 

Bhat A, Asghar M, Raulia G, Mandal AK. Improving multidisciplinary severe sepsis management using the Sepsis Six. Clin Med (Lond). 2016;16(6):503–5.

Article  PubMed  Google Scholar 

Michell W. Sepsis-follow the guidelines. S Afr J Crit Care. 2018;34(1):2.

Article  Google Scholar 

Bhagwanjee S, Paruk F, Scribante J, Perrie H. Compliance with the surviving sepsis guidelines: a review of South African intensive care units. Crit Care. 2007;11(2):P72.

Article  PubMed Central  Google Scholar 

Bhagwanjee S, Scribante J, Paruk F. Prevalence of ICU infection in South Africa and accuracy of treating physician diagnosis and treatment. Crit Care. 2009;13(Suppl 1):347. https://doi.org/10.1186/cc7511. Epub 2009 Mar 13.

Bhagwanjee S, Scribante J, Perrie H, Paruk F. PISA: the prevalence of infection in intensive care units in South Africa. Crit Care. 2007;11(Suppl 2):66. https://doi.org/10.1186/cc5226. Epub 2007 Mar 22.

Morton B, Stolbrink M, Kagima W, Rylance J, Mortimer K. The early recognition and management of sepsis in Sub-Saharan African adults: a systematic review and meta-analysis. Int J Environ Res Public Health. 2018;15(9).

Andrews B, Muchemwa L, Kelly P, Lakhi S, Heimburger DC, Bernard GR. Simplified severe sepsis protocol: a randomized controlled trial of modified early goal-directed therapy in Zambia. Crit Care Med. 2014;42(11):2315.

Article  PubMed  PubMed Central  Google Scholar 

Andrews B, Semler MW, Muchemwa L, Kelly P, Lakhi S, Heimburger DC, et al. Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial. JAMA. 2017;318(13):1233–40.

Article  PubMed  PubMed Central  Google Scholar 

Jacob ST, Banura P, Baeten JM, Moore CC, Meya D, Nakiyingi L, et al. The impact of early monitored management on survival in hospitalized adult Ugandan patients with severe sepsis: a prospective intervention study. Crit Care Med. 2012;40(7):2050.

Article  PubMed  PubMed Central  Google Scholar 

Anesi GL, Gabler NB, Allorto NL, Cairns C, Weissman GE, Kohn R, et al. Intensive care unit capacity strain and outcomes of critical illness in a resource-limited setting: a 2-hospital study in South Africa. J Intensive Care Med. 2020;35(10):1104–11.

Article  PubMed  Google Scholar 

Messina AP, van den Bergh D, Goff DA. Antimicrobial stewardship with pharmacist intervention improves timeliness of antimicrobials across thirty-three hospitals in South Africa. Infect Dis Ther. 2015;4(Suppl 1):5–14.

Article  PubMed  PubMed Central  Google Scholar 

National Infection Prevention and Control Strategic Framework. South Africa. Published by the South African Department of Health; March, 2020. https://knowledgehub.health.gov.za/elibrary/national-infection-prevention-and-control-strategic-framework-2020.

Choi JJ, McCarthy MW. The surviving sepsis controversy: a call to action for hospital medicine. Expert Rev Anti Infect Ther. 2018;16(12):889–92.

Article  CAS  PubMed  Google Scholar 

Han YY, Carcillo JA, Dragotta MA, Bills DM, Watson RS, Westerman ME, et al. Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics. 2003;112(4):793–9.

Article  PubMed  Google Scholar 

Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, Bion J, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med. 2010;38(2):367–74.

Article  PubMed  Google Scholar 

de Oliveira CF, de Oliveira DS, Gottschald AF, Moura JD, Costa GA, Ventura AC, et al. ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation. Intensive Care Med. 2008;34(6):1065–75.

Article  PubMed  Google Scholar 

Cruz AT, Perry AM, Williams EA, Graf JM, Wuestner ER, Patel B. Implementation of goal-directed therapy for children with suspected sepsis in the emergency department. Pediatrics. 2011;127(3):e758–66.

Article  PubMed  Google Scholar 

Larsen GY, Mecham N, Greenberg R. An emergency department septic shock protocol and care guideline for children initiated at triage. Pediatrics. 2011;127(6):e1585–92.

Article  PubMed  Google Scholar 

Baelani I, Jochberger S, Laimer T, Rex C, Baker T, Wilson IH, et al. Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces. Middle East J Anaesthesiol. 2012;21(4):559–75.

PubMed  Google Scholar 

Ninis N, Phillips C, Bailey L, Pollock JI, Nadel S, Britto J, et al. The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases. BMJ. 2005;330(7506):1475.

Article  PubMed  PubMed Central  Google Scholar 

Santhanam I, Kissoon N, Kamath SR, Ranjit S, Ramesh J, Shankar J. GAP between knowledge and skills for the implementation of the ACCM/PALS septic shock guidelines in India: is the bridge too far? Indian J Crit Care Med. 2009;13(2):54–8.

Article  PubMed  PubMed Central  Google Scholar 

Phua J, Koh Y, Du B, Tang YQ, Divatia JV, Tan CC, et al. Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ. 2011;342: d3245.

Article  PubMed  PubMed Central  Google Scholar 

Brunkhorst FM, Engel C, Ragaller M, Welte T, Rossaint R, Gerlach H, et al. Practice and perception–a nationwide survey of therapy habits in sepsis. Crit Care Med. 2008;36(10):2719–25.

Article  PubMed  Google Scholar 

Launay E, Gras-Le Guen C, Martinot A, Assathiany R, Blanchais T, Mourdi N, et al. Suboptimal care in the initial management of children who died from severe bacterial infection: a population-based confidential inquiry. Pediatr Crit Care Med. 2010;11(4):469–74.

PubMed  Google Scholar 

Inwald DP, Tasker RC, Peters MJ, Nadel S. Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit. Arch Dis Child. 2009;94(5):348–53.

Article  CAS  PubMed  Google Scholar 

McIntyre PB, Macintyre CR, Gilmour R, Wang H. A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis. Arch Dis Child. 2005;90(4):391–6.

Article  CAS