Closing the sepsis gap: from molecular mechanisms to scalable bedside care

Recent estimates point to roughly 49 million cases and 11-13 million deaths annually due to sepsis, with a disproportionate burden borne by low- and middle-income countries. Three decades of progress, summarised in the recently updated Surviving Sepsis Campaign guidelines, have refined how clinicians screen for, resuscitate, and treat patients with sepsis. Yet, persistent uncertainty surrounds early identification, pathogen detection, hemodynamic targets, adjunctive therapies, and the long-term burden carried by survivors. This Collection, Sepsis: Treatment, intervention, mortality, brings together original research that maps where the field is moving: pragmatic diagnostics that run on standard hospital equipment; multi-omic biomarker discovery in blood, plasma extracellular vesicles, and urine; computational dissection of pathogen biology and longitudinal host-response trajectories; preclinical interrogation of metabolic and signalling pathways implicated in organ injury; and mechanistic studies of the muscle and mitochondrial wasting that shape life after sepsis. Together, these papers sketch a research agenda for sepsis that is simultaneously molecularly precise and operationally scalable.