Sepsis is a potentially life-threatening complication resulting from infection, anything from a simple scratch on the knee to some contamination acquired while in the hospital. Anyone can develop sepsis, a leading cause of death among hospital patients. Now, researchers from the Washington University School of Medicine have found a link between late-stage sepsis and reactivation of otherwise-dormant viruses in the body. "We think this paper will stimulate others to carry out further investigations of the role of latent viruses in sepsis," said Dr. Gregory Storch, co-author of the study.  

What is Sepsis?

When your body releases chemicals into the bloodstream to fight infection sometimes this can trigger inflammation throughout the body — this is called sepsis. Such widespread inflammation may easily damage organ systems, such as your heart, and even cause organ failure. In such cases, a patient may go into septic shock, with blood pressure dropping dramatically. Death is the next and final stop. Chances for survival improve tremendously with early treatment, usually a massive dose of antibiotics and intravenous fluids combined.

For the current study, the team of researchers hypothesized sepsis may effect more subtle changes in the body than previously imagined. Under normal conditions in a healthy person, dormant viruses are kept in check by the immune system. The team theorized inactive viruses may re-emerge and enter the bloodstream during sepsis, and this is why a patient's immune system becomes overwhelmed and unable to fight.

To investigate, the team used polymerase chain reaction (PCR) testing to detect a range of viruses in blood and urine samples from critically ill patients with sepsis. As a comparison, they performed the same test on critically ill patients in the hospital who did not have sepsis and healthy patients who were having outpatient surgery.  

What did the researchers discover? Septic patients with higher levels of viruses in their blood were more likely than those with less viruses to have more severe illness, secondary fungal and bacterial infections, and longer stays in the intensive care unit. Of the septic patients, 78 percent for torque teno virus, a virus transmitted by transfusion; 53 percent for Epstein-Barr virus; 24 percent tested positive for cytomegalovirus; 14 percent for herpes simplex viruses one and two; and 10 percent for herpes virus six.

"We stumbled onto more viruses than we expected, and we don't know yet whether some of these viruses are causing problems in their own right," Storch stated in a press release.

Crucially, some septic patients initially tested negative for a virus and then subsequently tested positive during the course of their sepsis. These findings, Storch believes, suggest immunotherapy drugs, which stimulate the immune system, might be incorporated into the treatment of late-stage sepsis as a way to improve a patient’s survival odds.

 

Source: Walton AH, Muenzer JT, Rasche D, et al. Reactivation of Multiple Viruses in Patients with Sepsis. PLoS ONE. 2014.