title: The Knowledge of the Physicians about Sepsis Bundles is Suboptimal: A Multicenter Survey.
abstract: OBJECTIVE
  Sepsis is a severe condition with possible high mortality outcomes. A multicentre-survey to detect the knowledge of the physicians who are involved in sepsis management in daily work was conducted.
  
  
  METHODS
  The study was held in October 2013. A questionnaire consisting of questions about sepsis bundles was prepared. Eight centers from different regions of the country were invited to join the survey. The questionnaires were introduced to physicians from infectious diseases, internal diseases, emergency (ER) and anaesthesiology departments.
  
  
  RESULTS
  Two-hundred-and-twenty-three physicians from eight different centers were included. Of total 112 (50%) were male, median age was 30 years (24-59 years). Median working duration of participants was 5 years; 153 (69%) were residents, 70 (31%) were consultants. Of total 131 (59%) declared that they have enough knowledge on sepsis management. About the most important approach in sepsis, 151 (68%) voted for fluid replacement while 59 (26%) and 13 (6%) said early antibiotic use and inotropic support are the most important approaches respectively. Physicians from ER (56.5%) and anaesthesiology departments (55.4%) were more aware of the fluid replacement element of the bundle (30ml/kg, 3-hours bundle) in severe sepsis. The ID physicians, who routinely follow sepsis patients, were not aware of the fluid resuscitation (only 20% replied the element correctly) but almost all of them answered the question on early antibiotic use and blood culture sampling correctly. The knowledge of target CVP and MAP in severe sepsis were also below expectant among ID physicians. The overall knowledge of sepsis bundles of internal medicine physicians was poor. Almost all of the ER physicians knew that they have to measure lactate level upon admission but they were not aware of the threshold of the lactate level.
  
  
  CONCLUSIONS
  The knowledge of the sepsis bundles of the physicians, who are in charge of sepsis patients in routine work, was suboptimal. Most of the participants were unaware of SSC and new bundles. Training of the physicians of all centers about sepsis bundles is suggested according to these results.
authors.affiliation: Associate Professor, Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital , Ankara, Turkey .
authors.forename: Zeliha Kocak
authors.initials: ZK
authors.lastname: Tufan
authors.affiliation: Faculty, Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital , Ankara, Turkey .
authors.forename: Fatma Civelek
authors.initials: FC
authors.lastname: Eser
authors.affiliation: Faculty, Department of Infectious Disease and Clinical Microbiology, Ankara Training and Research Hospital , Ankara, Turkey .
authors.forename: Emre
authors.initials: E
authors.lastname: Vudali
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Dr. Lutfi Kirdar Kartal Training and Research Hospital , Istanbul, Turkey .
authors.forename: Ayse
authors.initials: A
authors.lastname: Batirel
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital , Ankara, Turkey .
authors.forename: Bircan
authors.initials: B
authors.lastname: Kayaaslan
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Numune Training and Research Hospital , Ankara, Turkey .
authors.forename: Aliye Tanrici
authors.initials: AT
authors.lastname: Bastug
authors.affiliation: Faculty, Department of Infectious Disease and Clinical Microbiology, GATA Haydarpasa Training and Research Hospital , Istanbul, Turkey .
authors.forename: Deniz
authors.initials: D
authors.lastname: Eray
authors.affiliation: Associate Professor, Department of Infectious Disease and Clinical Microbiology, GATA Haydarpasa Training and Research Hospital , Istanbul, Turkey .
authors.forename: Vedat
authors.initials: V
authors.lastname: Turhan
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Gaziosmanpasa University Faculty of Medicine , Tokat, Turkey .
authors.forename: Fazilet
authors.initials: F
authors.lastname: Duygu
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Turkish Armed Forces Health Command Health and Veterinary Services , Ankara, Turkey .
authors.forename: Duran
authors.initials: D
authors.lastname: Tok
authors.affiliation: Specialist, Department of Infectious Disease and Clinical Microbiology, Sarikamis Public Hospital , Kars, Turkey .
authors.forename: Serife
authors.initials: S
authors.lastname: Altun
authors.affiliation: Associate Professor, Department of Infectious Disease and Clinical Microbiology, Ankara Training and Research Hospital , Ankara, Turkey .
authors.forename: Cemal
authors.initials: C
authors.lastname: Bulut
authors.affiliation: Professor, Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital , Ankara, Turkey .
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Tasyaran
keywords: Improvement; Sepsis performance; Septic shock; Severe sepsis; Surviving sepsis campaign