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S C HW E R P U N K T 20 Achilles’ heel immune system Despite modern medicine—or perhaps because of it—sepsis ranks among the most frequent causes of death in Germany. Although sepsis is predominantly triggered by bacteria, it is fungi, for example Candida albicans , which increasingly cause a deadly course. Prof. Dr Michael Bauer investigates severe and life-threatening infections at the Jena University Hospital and at the Center for Sepsis Control and Care (CSCC). In order to understand how microorganisms communi- cate within the human body, he wants to learn from biologists. BY JULIANE DÖLITZSCH It is not only its name which seems devastating, it is devastating itself: sep- sis is a false, self-destructive reaction of the human body. »According to the current definition, sepsis is an organ failure resulting from inadequate re- sponse of the organism to an infection,« explains Prof. Dr Michael Bauer, an ex- pert in intensive care medicine at the Jena University Hospital. During sep- sis, a life-threatening infection gets out of control and the stress response of the body harms its own tissue and organs: »Instead of directing its full rage against the pathogen, the immune system turns against the host itself. The body’s repair systems fail.« Sepsis may lead to shock, multiple organ failure, and ultimately to death, especially if it is not recognized ear- ly and treated promptly. Sepsis is the leading cause of death from infection in the world. In Germany, for instance, approximately 280,000 new cases of sepsis occur every year killing almost a quarter of the affected patients. The si- tuation in Jena reflects these data. »Out of 400 patients, we lose around 100 be- cause of the insidious disease,« reports Bauer, who is also the speaker of the CSCC. Sepsis may occur as a complica- tion of any infection, for example pneu- monia, tonsillitis or urinary tract infec- tions, not to mention those following injuries or surgical procedures. Thus every medical speciality has to deal with the problem. In most cases sepsis is caused by bacte- rial pathogens, for instance Staphylococ- cus aureus or Escherichia coli . When the disease seems to be overcome, danger can be still imminent: »A second sep- tic episode is, in more than 30 percent of the cases, due to a fungal infection,« specifies Michael Bauer. »It is rather dif- ficult to detect fungi and our diagnostic methods are not fast enough. Detection using blood cultures takes days, but pa-