{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:23:29Z","timestamp":1783833809957,"version":"3.55.0"},"reference-count":101,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T00:00:00Z","timestamp":1584576000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:p>\n                    The definition of sepsis continues to be as dynamic as the management strategies used to treat this. Sepsis-3 has replaced the earlier systemic inflammatory response syndrome (SIRS)-based diagnoses with the rapid Sequential Organ Failure Assessment (SOFA) score assisting in predicting overall prognosis with regards to mortality. Surgeons have an important role in ensuring adequate source control while recognizing the threat of carbapenem-resistance in gram-negative organisms. Rapid diagnostic tests are being used increasingly for the early identification of multi-drug\u2013resistant organisms (MDROs), with a key emphasis on the multidisciplinary alert of results. Novel, higher generation antibiotic agents have been developed for resistance in ESKCAPE (\n                    <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">Enterobacter<\/jats:italic>\n                    species) organisms while surgeons have an important role in the prevention of spread. The Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial has challenged the previous paradigm of length of antibiotic treatment whereas biomarkers such as procalcitonin are playing a prominent role in individualizing therapy. Several novel therapies for refractory septic shock, while still investigational, are gaining prominence rapidly (such as vitamin C) whereas others await further clinical trials. Management strategies presented as care bundles continue to be updated by the Surviving Sepsis Campaign, yet still remain controversial in its global adoption. We have broadened our temporal and epidemiologic perspective of sepsis by understanding it both as an acute, time-sensitive, life-threatening illness to a chronic condition that increases the risk of mortality up to five years post-discharge. Artificial intelligence, machine learning, and bedside scoring systems can assist the clinician in predicting post-operative sepsis. The public health role of the surgeon is key. This includes collaboration and multi-disciplinary antibiotic stewardship at a hospital level. It also requires controlling pharmaceutical sales and the unregulated dispensing of antibiotic agents globally through policy initiatives to control emerging resistance through prevention.\n                  <\/jats:p>","DOI":"10.1089\/sur.2019.126","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T11:03:02Z","timestamp":1574420582000},"page":"195-204","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Sepsis 2019: What Surgeons Need to Know"],"prefix":"10.1177","volume":"21","author":[{"given":"Vanessa P.","family":"Ho","sequence":"first","affiliation":[{"name":"Division of Trauma, Critical Care, Burns, and Acute Care Surgery, MetroHealth Medical Center, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham","family":"Kaafarani","sequence":"additional","affiliation":[{"name":"Trauma, Emergency Surgery and Surgical Critical Care, Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Rattan","sequence":"additional","affiliation":[{"name":"Division of Trauma and Surgical Critical Care, University of Miami Miller School of Medicine, Miami, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Namias","sequence":"additional","affiliation":[{"name":"Division of Trauma and Surgical Critical Care, University of Miami Miller School of Medicine, Miami, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Evans","sequence":"additional","affiliation":[{"name":"Division of General &amp; Acute Care Surgery, Medical University of South Carolina, Charleston, South Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya L.","family":"Zakrison","sequence":"additional","affiliation":[{"name":"Section for Trauma and Acute Care Surgery, The University of Chicago Medicine, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,3,19]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp068197"},{"key":"e_1_3_4_3_2","unstructured":"FDA Drug Safety Communication: Voluntary market withdrawal of Xigris [drotrecogin alfa (activated)] due to failure to show a survival benefit. 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