The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.

1st Department of Surgery 1st Faculty of Medicine Charles University Prague Prague Czech Republic

2nd Surgical Clinic Emergency Hospital of Craiova Craiova Romania

3rd Department of General Surgery Jagiellonian University Medical College Krakow Poland

472nd Department of General Surgery Jagiellonian University Medical College Krakow Poland

96th Department of Internal Medicine Hygeia General Hospital Athens Greece

Clinic for Emergency Surgery Medical Faculty University of Belgrade Belgrade Serbia

Clinical Research Center Fundacion Valle del Lili Cali Colombia

College of Medicine Alfaisal University Riyadh Saudi Arabia

Colorectal Unit Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust Cambridge UK

Department General Surgery Kipshidze Central University Hospital Tbilisi Georgia

Department of Aeromedical Services for Emergency and Trauma Care Graduate School of Medicine Ehime University Ehime Japan

Department of Anesthesia and Intensive Care Azienda Ospedaliero Universitaria Parma Parma Italy

Department of Clinical and Experimental Sciences University of Brescia Brescia Italy

Department of Clinical Research and Innovation in Pneumonia and Sepsis Vall d'Hebron Institute of Research Barcelona Spain

Department of Digestive Surgery Cannes Hospital Cannes France

Department of Emergency and Critical Care Medicine Taipei Medical University Hospital Taipei Taiwan

Department of Emergency Medicine Santa Maria Misericordia University Hospital Udine Italy

Department of Emergency Surgery City Hospital Mozyr Belarus

Department of Emergency Surgery Parma Maggiore Hospital Parma Italy

Department of General and Emergency Surgery Riga East University Hospital Gailezers Riga Latvia

Department of General Surgery Division of Surgery Rambam Health Care Campus Haifa Israel

Department of General Surgery Faculty of Medicine Erzincan University Erzincan Turkey

Department of General Surgery Hospital San Juan de Dios de La Serena La Serena Chile

Department of General Surgery Kuala Krai Hospital Kelantan Malaysia

Department of General Surgery Mansoura Faculty of Medicine Mansoura University Mansoura Egypt

Department of Internal Medicine Royal Hospital Muscat Oman

Department of Medicine Infectious Disease Division King Fahad Medical City Riyadh Saudi Arabia

Department of Medicine Northeast Ohio Medical University Rootstown OH USA

Department of Primary Care and Emergency Medicine Graduate School of Medicine Kyoto University Kyoto Japan

Department of Surgery and Critical Care Universidad del Valle Fundación Valle del Lili Cali Colombia

Department of Surgery Bizerte Hospital Bizerte Tunisia

Department of Surgery College of Health Sciences Obafemi Awolowo University Ile Ife Nigeria

Department of Surgery College of Medicine and Health Sciences UAE University Al Ain United Arab Emirates

Department of Surgery College of Medicine Yonsei University Seoul South Korea

Department of Surgery Denver Health Medical Center University of Colorado Denver CO USA

Department of Surgery Division of Acute Care Surgery and Center for Sepsis and Critical Illness Research College of Medicine University of Florida Gainesville FL USA

Department of Surgery Division of Trauma University of Arizona Tucson AZ USA

Department of Surgery Emergency Hospital of Bucharest Bucharest Romania

Department of Surgery Faculty of Medicine Thammasat University Hospital Thammasat University Rangsit Pathum Thani Thailand

Department of Surgery Hassan 2 University Hospital Medical School of Fez Sidi Mohamed Benabdellah University Fez Morocco

Department of Surgery Hospital Universitário Terezinha de Jesus Faculdade de Ciências Médicas e da Saúde de Juiz de Fora Juiz de Fora Brazil

Department of Surgery Macerata Hospital Macerata Italy

Department of Surgery Nelson R Mandela School of Clinical Medicine Durban South Africa

Department of Surgery North Estonia Medical Center Tallinn Estonia

Department of Surgery Patan Hospital Patan Academy of Health Sciences Lalitpur Kathmandu Nepal

Department of Surgery Post Graduate Institute of Medical Sciences Rohtak India

Department of Surgery Radiology University Hospital of the West Indies Kingston Jamaica

Department of Surgery School of Medicine Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre Brazil

Department of Surgery The Brunei Cancer Centre Jerudong Park Jerudong Brunei

Department of Surgery Tianjin Nankai Hospital Nankai Clinical School of Medicine Tianjin Medical University Tianjin China

Department of Surgery UMC Ljubljana Ljubljana Slovenia

Department of Surgery Universidad Nacional de Asuncion Asuncion Paraguay

Department of Surgery University Hospital Centre Zagreb Croatia

Department of Surgery University Hospital of Trauma Tirana Albania

Department of Surgery University of Ilorin Teaching Hospital Ilorin Nigeria

Department of Surgery University of KwaZulu Natal Durban South Africa

Department of Surgery Virginia Commonwealth University Richmond VA USA

Division of Acute Care Surgery Program in Trauma R Adams Cowley Shock Trauma Center University of Maryland Baltimore MD USA

Division of Infectious Diseases Cleveland Clinic Akron General Akron OH USA

Division of Infectious Diseases Department of Internal Medicine American University of Beirut Beirut Lebanon

Division of Trauma Surgery Department of Surgery School of Medical Sciences University of Campinas Campinas SP Brazil

Drug Applied Research Center Tabriz University of Medical Sciences Tabriz Iran

Emergency Post Operative Department Otavio De Freitas Hospital Recife Brazil

General Surgery Department Bufalini Hospital Cesena Italy

General Surgery Department Medical University University Hospital St George Plovdiv Bulgaria

General University Hospital Prague Prague Czech Republic

Global Alliance for Infections in Surgery Porto Portugal

Infectious Diseases Division Department of Medicine Prince Mohamed Bin Abdulaziz Hospital Ministry of Health Riyadh Saudi Arabia

Infectious Diseases Division Santa Maria Misericordia University Hospital Udine Italy

Istituto Clinico San Rocco di Franciacorta Brescia Italy

Laboratory of Clinical Microbiology Department of Infectious Diseases Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico

Osvaldo Cruz Hospital Recife Recife Brazil

Research Unit Health Policy Consult Weija Accra Ghana

School of Pharmacy Faculty of Medical Sciences The University of the West Indies St Augustine Eric Williams Medical Sciences Complex Uriah Butler Highway Champ Fleurs Trinidad and Tobago

Sudan National Public Health Laboratory Federal Ministry of Health Khartoum Sudan

Surgical Disciplines Immanuel Kant Baltic Federal University Regional Clinical Hospital Kaliningrad Russian Federation

Trauma and Acute Care Surgery Unit Hadassah Hebrew University Medical Center Jerusalem Israel

Trauma Service Inkosi Albert Luthuli Central Hospital Durban South Africa

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