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Blacks are at a higher risk than whites for developing infections and organ injury that can cause severe sepsis, a new study suggests.

Severe sepsis, a life-threatening blood infection, occurs when an initial bacterial infection overwhelms the body’s immune system, causing blood clots to form and block blood flow to organs. This can lead to organ failure and death.

Though the researchers at the University of Pittsburgh have known for sometime that black patients are more likely to develop severe sepsis over white patients, they were uncertain whether these disparities were caused by differences in susceptibility to infection rates or in the risk of developing organ dysfunction once infection has occurred, said Dr. Florian B. Mayr, lead author of the study.

After examining data from hospitals in seven states and data on infection-related hospital visits, researchers found that both factors contribute to the higher rate of severe sepsis.

The study shows that blacks, compared to whites, had a 67 percent higher rate of severe sepsis and 80 percent higher mortality. Infection rates were 47 blacks and 34 whites per 1,000 people, and organ dysfunction rates were 29 percent higher in blacks than whites.

These findings are an important step in developing interventions to reduce these disparities, Mayr said.

“Many people know about heart attacks and kidney disease, but very few people actually know what severe sepsis is or what causes it,” he said. “I think education of the general population is important.”

Severe sepsis affects 750,000 people a year, and one in four people who develop the illness will die from it.

Mayr said individuals, communities, health care providers and policymakers all share the responsibility of reducing the disparities. Individuals must regularly receive the proper vaccinations, while health care providers must ensure access to quality care since severe sepsis rates are higher in hospitals that predominantly serve blacks, he said.

The study also found that racial disparities were the largest among younger adults.
“We were stunned by that finding,” Mayr said. “We do not have a good explanation for that so far.”

The researchers are now working on identifying reasons for the findings of this study. Mayr said both biological and socioeconomic differences could contribute to the disparities.

“I’m certain we have to improve and expand our work on understanding social variables,” he said. “But on the other end, we’re interested in looking into the biological explanations and if there are differences in response to infection. We have to consider every piece.”

Photo by Steve Savage