The state's septicaemia deaths accounted for 20.2 percent of the national total of 1,03,977 deaths from bloodstream infections.
Published Dec 30, 2025 | 12:50 PM ⚊ Updated Dec 30, 2025 | 12:50 PM
Tamil Nadu records one in five sepsis deaths in India. (Supplied)
Synopsis: Tamil Nadu’s 20,957 septicaemia deaths exceed the combined totals of Karnataka (4,325), Andhra Pradesh (4,060), Telangana (1,775), Kerala (650), and Puducherry (1,460), which together account for 12,270 deaths. The state alone records 70.7 percent more septicaemia deaths than all other southern states combined.
When patients walked into a dental clinic in Vaniyambadi seeking treatment for routine tooth problems in 2022, they could not have imagined they would leave with a deadly brain infection.
Nine died and eight were left with lasting disabilities after contaminated saline used during dental procedures infected them with neuro melioidosis, a rare and fatal bloodstream infection. The outbreak, traced to a half-used saline bottle reused across multiple patients, exposed critical lapses in basic hygiene protocols at the clinic.
The Vaniyambadi incident, documented in The Lancet Regional Health, represents just one visible example of a far larger problem.
Tamil Nadu recorded 20,957 septicaemia or sepsis deaths in 2023, representing one in five bloodstream infection fatalities in India and the highest absolute burden in the country, according to the Report on Medical Certification of Cause of Death released by the Office of the Registrar General of India.
The state’s septicaemia deaths accounted for 20.2 percent of the national total of 1,03,977 deaths from bloodstream infections, a disproportionately high share given that Tamil Nadu represents only 14.3 per cent of India’s 19,00,956 medically certified deaths.
This over-representation by approximately 40 percent raises critical questions about healthcare-associated infection rates, antibiotic resistance patterns, and infection control protocols in the state’s medical facilities.
Septicaemia, or bloodstream infection, occurs when bacteria or other pathogens enter the bloodstream and trigger a systemic inflammatory response. It represents the most severe form of infection and frequently originates from hospital procedures, invasive medical devices, or complications of existing illnesses.
Nationally, septicaemia accounts for 5.5 percent of all medically certified deaths and represents 63.1 percent of deaths within the infectious and parasitic diseases category.
Of Tamil Nadu’s 20,957 septicaemia deaths, 12,550 were males (59.9 percent) and 8,407 were females (40.1 percent). This represents 7.7 percent of the state’s 2,71,047 medically certified deaths, placing septicaemia as a major mortality cause after cardiovascular diseases (49.3 percent), respiratory diseases (9.6 percent), and infectious diseases (9.5 percent).
The male-to-female ratio of 1.5:1 in septicaemia deaths mirrors the national pattern, suggesting males face consistently higher risk of bloodstream infections across all states. This gender disparity may reflect higher rates of invasive medical procedures among men, occupational exposures, delayed healthcare seeking behaviour, or biological susceptibility differences.
Tamil Nadu’s 20,957 septicaemia deaths exceed the combined totals of Karnataka (4,325), Andhra Pradesh (4,060), Telangana (1,775), Kerala (650), and Puducherry (1,460), which together account for 12,270 deaths. The state alone records 70.7 percent more septicaemia deaths than all other southern states combined.
Tamil Nadu reports elevated sepsis cases due to endemic infections like melioidosis, healthcare-associated lapses, and high-risk factors such as diabetes and monsoon exposure.
Endemic melioidosis, caused by Burkholderia pseudomallei in soil and water, drives many sepsis cases, with surges during rainy seasons (June-December) linked to percutaneous exposure in agriculture-heavy areas. High diabetes prevalence, intensive farming, and population density amplify risks.
In 2022-2023, one hospital reported 83 culture-proven melioidosis cases, mostly septicemic, highlighting sporadic environmental and iatrogenic transmission. These events underscore poor sterilization and delayed diagnostics as amplifiers.
India’s sepsis burden is high, with over 50 percent of ICU patients affected nationally, but Tamil Nadu’s tropical climate and agricultural practices create hotspots. Neonatal and burn sepsis add to incidence, driven by E. coli and Klebsiella in vulnerable groups. Enhanced surveillance and early antibiotics could mitigate, given septic shock mortality near 50 percent.
West Bengal recorded the second highest septicaemia burden at 17,800 deaths (17.1 percent of the national total), comprising 10,084 male deaths and 7,716 female deaths. This represents 13.3 percent of West Bengal’s 134,093 medically certified deaths, nearly double the percentage seen in Tamil Nadu and indicating an even more severe relative burden.
Delhi reported 15,332 septicaemia deaths (14.7 percent of national total), with 8,964 male deaths and 6,366 female deaths. This accounts for 17.5 percent of Delhi’s 87,418 medically certified deaths, the highest percentage among major states and suggesting either superior diagnostic capabilities, higher hospital-acquired infection rates, or a population particularly vulnerable to bloodstream infections.
Maharashtra recorded 9,152 septicaemia deaths (8.8 percent of national total), while Gujarat reported 5,015 deaths (4.8 percent). These five states together account for 68,256 septicaemia deaths, representing 65.6 percent of national bloodstream infection mortality.
Tamil Nadu, West Bengal, and Delhi alone account for 54,089 deaths, more than half (52 percent) of India’s septicaemia mortality burden. This concentration in three states raises questions about whether other regions are underdiagnosing or underreporting bloodstream infections.
Across southern states, 31,327 septicaemia deaths were recorded (30.1 percent of the national total), with males accounting for 19,968 deaths (63.8 percent) and females 11,359 deaths (36.2 percent).
Karnataka reported 4,325 septicaemia deaths (2,678 males and 1,647 females), representing 3.0 percent of the state’s 144,189 medically certified deaths. This is significantly lower than Tamil Nadu’s 7.7 percent, despite Karnataka having a comparable healthcare infrastructure and medical certification rate (26.7 percent).
Andhra Pradesh recorded 4,060 septicaemia deaths (2,387 males and 1,673 females), accounting for 5.2 percent of the state’s 78,522 medically certified deaths. Telangana reported 1,775 deaths (1,045 males and 730 females), representing 1.9 percent of 92,068 medically certified deaths.
Kerala recorded only 650 septicaemia deaths (374 males and 276 females), the lowest absolute number among major southern states and representing just 1.9 percent of the state’s 34,613 medically certified deaths. This is particularly notable given Kerala’s high rates of diabetes mortality (19.1 percent) and cancer deaths (13.6 percent), conditions that typically increase susceptibility to infections.
Puducherry reported 1,460 septicaemia deaths (934 males and 526 females), but this represents 11.9 percent of the union territory’s 12,237 medically certified deaths, the second highest percentage in southern India after Delhi.
Across all states, males consistently account for approximately 60 percent of septicaemia deaths, with females representing 40 percent. This 1.5:1 male-to-female ratio holds remarkably consistent from Tamil Nadu (1.49:1) to West Bengal (1.31:1) to Delhi (1.41:1).
The gender gap may reflect multiple factors. Males undergo invasive medical procedures at higher rates, face greater occupational exposures to infections, often delay seeking healthcare until conditions become severe, and may have biological susceptibility differences affecting immune response to bloodstream infections.
Maharashtra shows the widest gender gap at 2.23:1 (6,316 male deaths versus 2,836 female deaths), while states like Bihar (1.03:1) and Goa (0.98:1) show near parity, suggesting state-specific factors influencing gender patterns in septicaemia mortality.
(Edited by Sumavarsha)
