By Karen Auge, Denver Post Medical Writer
Until it nearly killed him, Jason Wright had never heard of sepsis.

Post / Brian Brainerd Littleton resident Jason Wright contracted a life-threatening sepsis infection days after being injured in a motorcycle accident.

That's not surprising.

Sepsis doesn't get a lot of attention. There are no patient support groups, no high-profile organizations lobbying for research dollars. There are no 5Ks or telethons to find a sepsis cure.

But doctors and nurses who work in hospitals know it all too well.

They know sepsis, septicemia and septic shock as a menacing trio that stalks hospital corridors and intensive-care units and infects an estimated 750,000 people a year in the United States. The number of septicemia deaths reported to the Centers for Disease Control and Prevention stood at 32,275 in 2001, but researchers say the number of annual deaths from severe sepsis and septic shock is closer to 225,000, more than breast and colon cancer combined.

Insurance companies, too, know sepsis as a condition that costs, on average, $22,000 per case - $17 billion a year - to treat, according to recent studies.

Severe sepsis - defined as a massive infection that sets off chemical reactions that can cause organs to shut down - kills about a third of patients who get it. And with septic shock, the odds are even worse - if infection progresses to that stage, the patient has no better than a 50-50 shot at surviving.

Sepsis is inexplicably on the rise. Last year, the CDC and Emory University released results of a study that found the rate of sepsis infections rose an average of 16 percent a year in the two decades between 1979 and 1999, for a total increase of 329 percent.

In Colorado, hospitals reported treating 2,038 cases of septicemia in adults in 2000. Of those, 319 died. Last year, the number had risen to 2,274, causing 360 deaths, according to the Colorado Health and Hospital Association.

The numbers could very well be higher. The national organization that inspects and accredits health care facilities recently chastised hospitals for reporting only a fraction of the infections hatched in their corridors.

Dr. Edward Abraham, head of critical-care medicine at University of Colorado Hospital, said University has "several of these patients a week." The majority arrive at the hospital with sepsis already raging, he said.

"It's the most common cause of death in the ICU," he said.

But research in hospitals around the country, including University of Colorado Hospital, Swedish Medical Center, Denver Health Medical Center and others, is trying to change that.

At CU, Abraham is heading up two of those research efforts.

One, a study that began last fall with a National Institutes of Health grant, is exploring the central mystery of life-threatening septic infections - namely, why some patients develop them while others fight them off.

"Even with the best possible care, there is still going to be a finite number of people who are going to get infections," Abraham said. "We're looking at the genetic background of why some patients develop infections and other patients, of the same age and same gender, don't."

Abraham is also lead investigator in two trials of a sepsis-fighting drug called Xigris. That's the drug that Wright and his parents credit with saving his life.

Wright was lucky. His doctor, John Kepros, a trauma surgeon at Swedish Medical Center, is also involved in sepsis research.

And Swedish was one of 300 hospitals nationwide, including CU, Denver Health and St. Anthony, that participated in tests of Xigris on the sickest sepsis patients. The results of those trials led to Food and Drug Administration approval of the drug as a sepsis treatment in 2001.

In clinical trials on more than 1,700 of the sickest sepsis patients, death rates dropped by 6 percent, from 31 percent of patients to 25 percent. That may not sound like much, but Kepros said it's the best any sepsis drug has ever done.

Now, Kepros, Abraham and colleagues across the country are testing Xigris on sepsis patients who aren't quite as bad off.

They're also trying to determine whether the drug's side effects - it causes bleeding in some patients - outweigh its benefits among patients not as severely ill.

ON THE WEB

For more information on sepsis, go to SurvivingSepsis.org.

Wright was on his motorcycle, headed to work Oct. 26 when he took a corner a little too fast. "The bike got away from me, and I hit a fire hydrant and a tree. The bike shattered into a million pieces," he said. "I'd be dead if I wasn't wearing a helmet."

As it is, he broke his leg in three places, broke bones in the base of his skull where his head joins his spine, and dislocated his elbow.

But his real problems started about two days later.

That's when he started having serious trouble breathing. Four days after his accident, doctors performed a tracheostomy so Wright could breathe. A week after the accident, his heart rate went up wildly, a count of his white blood cells indicated an acute infection, and his kidneys started to fail - all signs of sepsis.

Sepsis often attacks patients who have undergone some kind of trauma, such as a car accident, surgery or burns. It is also common in people who have cancer or pneumonia or compromised immune systems.

But many sepsis infections are born in hospitals, usually from invading bacteria. Often, those bacteria enter the body at the spot where IVs or catheters are inserted, or breed in the lungs of patients who have been on ventilators to help them breathe, Kepros said.

Fear of sepsis is one reason, along with saving money, that doctors try to get patients out of the hospital as fast as possible, before they catch any nasty bugs.

"Now the focus is on preventing infection to begin with," by encouraging diligent hand-washing, Kepros said.

But as Wright knows, those measures don't always work.

Doctors never said Jason's outlook was bleak, his father, Larry Wright said. Later, he said they learned that staff in the ICU didn't give his son much chance of surviving.

To keep him alive, doctors put him on a ventilator, gave him insulin when his body could no longer regulate his blood sugar and put him on dialysis when his kidneys started failing.

And Wright got doses of Xigris, the first drug approved for use against sepsis.

But a lot of patients aren't getting the latest treatment because their doctors may not know about it, Kepros said.

"It's been hard to get physicians' awareness up," he said.

Wright doesn't remember much of the treatment he got during his four weeks in intensive care. He just knows that he was lucky - two months after he started out on