World Day

Infections: 250,000 cases of sepsis a year, but in Italia there are disparities in treatment between the North and the South

Every hour’s delay in treatment reduces the chances of survival by 7–8 per cent: ‘Cittadinanza’ has published a position paper and a list of the necessary measures

by Health Editorial Team

7 September 2026

Aggiungi Il Sole 24 Ore
ai preferiti su Google

5' min read

Translated by AI

Versione italiana

5' min read

Translated by AI

Versione italiana

In Italia, there are an estimated 250,000 cases of sepsis each year, with between 50,000 and 70,000 deaths, according to figures from the Ministry of Health and the Siaarti scientific society. Around half of survivors develop Post-Sepsis Syndrome, characterised by cognitive impairment, mental health disorders and persistent physical weakness; in Italy, one third of elderly patients who survive a sepsis episode still die within a year of discharge due to residual frailty.
In Europe, sepsis affects around 377 people per 100,000 inhabitants each year: an incidence higher than that of myocardial infarction and stroke, the two best-known time-sensitive emergencies. Yet, unlike these conditions, sepsis remains largely unknown to the general public and lacks standardised protocols across all healthcare facilities.

The identikit

Sepsis is the body’s dysregulated response to an infection, capable of damaging its own organs to the point of multi-organ failure. When this response degenerates into severe circulatory, cellular and metabolic abnormalities, the condition is referred to as septicaemic shock: the most serious form of the disease, with an in-hospital mortality rate in Europe ranging from 20 per cent to 30 per cent, and exceeding 40 per cent in the most severe cases. Septic shock can result from delayed recognition of sepsis or from initial treatment that is either not prompt enough or not adequately targeted: for this reason, the speed of diagnosis is the only truly decisive factor in determining the prognosis.

‘Time’ is just as valuable as therapy

The most telling figure relates precisely to the time factor: every hour’s delay in administering targeted treatment, following the onset of shock, reduces the probability of survival by around 7–8 per cent. However, this margin is not uniformly guaranteed in Italian hospital practice, as revealed by the new Position Paper drawn up by Cittadinanzattiva and produced with the unconditional support of AOP Health: 68.6 per cent of healthcare professionals report significant differences in the management of sepsis between day/weekday and night/public holiday shifts, linked primarily to the reduced availability of microbiology laboratories and staff during the evening hours.

Mind-boggling figures

Globally, in 2021, sepsis accounted for 166 million cases and approximately 21.4 million deaths – 31.5 per cent of total global mortality – according to estimates by the GBD 2021 Global Sepsis Collaborators group published in *Lancet Global Health*. In Europe, around 3.4 million people are affected each year; 40 per cent of hospital admissions require a transfer to intensive care, with hospital stays on average three times longer than for other acute conditions.

The Position Paper

This document is the result of a public survey carried out by Cittadinanzattiva between 29 July 2025 and 31 January 2026, which gathered responses from 172 healthcare professionals – predominantly infectious disease specialists (55.9%), emergency medicine specialists (20 per cent) and anaesthetists and resuscitators (8.2 per cent) – as well as qualitative interviews with representatives of scientific societies and federations. The most frequently cited issue is the lack of standardised and agreed-upon protocols, reported by 55 per cent of professionals for sepsis and 41.9 per cent for septic shock. 35.3 per cent of respondents stated that their institution has no specific institutional protocol for the diagnosis of sepsis, a figure that falls to 31.4 per cent for septic shock. 70.9% identified communication or organisational issues in the coordination between the various units involved in patient management.

No follow-up in 73.3 per cent of centres

The most critical finding concerns the post-discharge period: 73.3 per cent of facilities do not have any structured follow-up programme for patients who have survived septic shock, and during the post-hospitalisation phase, 38.4 per cent of patients with sepsis have no designated healthcare professional to refer to. The complications most frequently reported by healthcare professionals are physical (58.1%), related to a lack of local referral services (47.7%) and cognitive (43%).

‘Recovering from sepsis or septic shock does not always mean returning to one’s former life. Survivors face an increased risk of mortality and readmission due to recurrent infections and sepsis, acute kidney injury and cardiovascular events, including heart attacks and strokes. Persistent physical, psychological and cognitive difficulties have a significant impact on recovery and quality of life,” explains Nicola Latronico, Full Professor of Anaesthesia and Intensive Care at the University of Brescia and Director of the Loto Research Centre (long-term outcomes for survivors of critical illness). Our experience with the post-intensive care clinic highlights just how important prolonged follow-up of the outcomes of sepsis or septic shock is for these patients. Without ongoing care, the transition from hospital to the community risks leaving patients and their families without adequate support, making it difficult to identify potentially treatable issues in a timely manner and to ensure continuity in their care and recovery pathway.”

The North-South divide

The survey highlights a marked regional disparity in the organisation of care pathways. In the North, 84.6 per cent of respondents reported the existence of a specific hospital protocol for sepsis, compared with 63.6 per cent in Central Italy and just 42.9 per cent in the South and on the Islands. The same disparity is observed in training: 61.5 per cent of healthcare facilities in the North offer specific courses, compared with 78.6 per cent reporting a lack of such courses in the South and on the islands. It is no coincidence that over 53 per cent of doctors in the South and on the islands believe that organisational shortcomings during night and public holiday shifts have a direct impact on patient survival, compared with 41 per cent of doctors in the North.

“Sepsis and septic shock pose a challenge to citizens’ right to safe healthcare. This means addressing early diagnosis, the timeliness of interventions, the quality of care pathways and continuity of care. “With this Position Paper, we have sought to offer a civic perspective which, drawing on the experience of professionals and patients, can help to support improvements to care pathways,” says Valeria Fava, Head of Health Policy Coordination at Cittadinanzattiva.

Recommendations

Based on the findings, the Position Paper sets out a number of recommendations, including:

• the standardisation of diagnostic, therapeutic and care pathways (PDTA) at national level;

• the guarantee of 24-hour continuity of care, with the same diagnostic and therapeutic standards across day, night and public holiday shifts;

• the establishment of structured follow-up programmes for survivors of sepsis and septicaemic shock;

• the enhancement of microbiological diagnostics and rapid diagnostic technologies;

• increasing the number of staff and expertise dedicated to the management of sepsis;

• ongoing, multidisciplinary and regular training programmes for all professionals involved;

• strengthening the integration between hospitals and the local community to ensure continuity of care;

• the development of systems for monitoring care processes and outcomes;

• the promotion of information and awareness-raising campaigns aimed at the public;

• shared governance between institutions, scientific societies and civic organisations to facilitate the implementation of the recommendations.

Brand connect

I prossimi eventi

Tutti gli eventi

Notizie e approfondimenti sugli avvenimenti politici, economici e finanziari.