Community-onset sepsis and its public health burden: a systematic review

Tsertsvadze, Alexander; Royle, Pamela; Seedat, Farah; Cooper, Jennifer; Crosby, Rebecca; McCarthy, Noel D.

doi:10.1186/s13643-016-0243-3

Cited by 29 publications

(17 citation statements)

References 67 publications

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“…Our inclusion criteria were designed to detect community-onset sepsis cases. Nosocomial sepsis accounts for approximately 10% of total cases and carries a higher mortality than community-onset disease [ 21 ]. Therefore, we are likely to have underreported nosocomial cases of sepsis and consequently the true sepsis-associated mortality in our population.…”

Section: Discussionmentioning

confidence: 99%

Evidence of High Mortality and Increasing Burden of Sepsis in a Regional Sample of the New Zealand Population

Huggan

Bell

Waetford

et al. 2017

Open Forum Infectious Diseases

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BackgroundSepsis is a life-threatening complication of infection. The incidence of sepsis is thought to be on the increase, but estimates making use of administrative data in the United States may be affected by administrative bias.MethodsWe studied the population-based incidence of sepsis in the Waikato region of New Zealand from 2007 to 2012 using International Classification of Diseases, Tenth Revision, Australian Modification, which lacks a specific code for sepsis.ResultsBetween 2007 and 2012, 1643 patients met coding criteria for sepsis in our hospitals. Sixty-three percent of patients were 65 or over, 17% of cases were admitted to an intensive care unit, and the in-hospital and 1-year mortality with sepsis was 19% and 38%, respectively. Age-standardized rate ratios (ASRRs) demonstrated that sepsis was associated with male sex (ASRR 1.4; 95% confidence interval [CI], 1.23–1.59), Maori ethnicity (ASRR 3.22 compared with non-Maori; 95% CI, 2.85–3.65), study year (ASRR 1.62 comparing 2012 with 2008; 95% CI, 1.18–2.24), and socioeconomic deprivation (ASRR 1.72 comparing the highest with the lowest quintile of socioeconomic deprivation; 95% CI, 1.5–1.97). Multiorgan failure was present in approximately 20% of cases in all age groups. Intensive care unit admission rate fell from 30% amongst 25- to 34-year-olds to less than 10% amongst those aged 75 and over.ConclusionsIn a 9% sample of the New Zealand population, the incidence of sepsis increased by 62% over a 5-year period. Maori, elderly, and disadvantaged populations were most affected.

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Section: Discussionmentioning

confidence: 99%

Evidence of High Mortality and Increasing Burden of Sepsis in a Regional Sample of the New Zealand Population

Huggan

Bell

Waetford

et al. 2017

Open Forum Infectious Diseases

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“…Bloodstream infections (BSIs) refer to various pathogenic microorganisms that have invaded the blood, primarily bacteria and fungi [1] . With the increasing number of invasive procedures and the unreasonable use of broadspectrum antibacterial drugs and corticosteroids, the incidence and mortality of BSIs increase annually, as has been reported in many studies [2,3] . For example, the incidence of BSIs increased by 64% from 945 to 1,546 per 100,000 hospitalized patients per year from 2000 to 2013 in a Swedish county, and the 30-day mortality of BSIs was up to 12.8% [4] .…”

Section: Introductionmentioning

confidence: 96%

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

Cui¹,

Li²,

Wang³

et al. 2020

Preprint

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Background Recent epidemiological studies on bloodstream infections (BSIs) that include the incidence rate, species distribution and dynamic changes are scarce in China. This study was performed to understand these epidemiological data of BSIs over the past 10 years in China. Method Using real-time nosocomial infection surveillance system, this study was retrospectively performed on BSIs in one of the largest hospitals in China, from January 2010 to December 2019. Results From 2010 to 2019, there were totally 9381 episodes of BSIs out of 1,437,927 adult hospitalized patients in the hospital, the total incidence rate of BSIs was 6.50‰ (6.50 episodes per 1000 adult-hospitalized patients per year) and the incidence rates had significantly decreased (8.24‰ to 6.00‰, time trend P <0.05). Among the 9381 episodes of BSIs, 93.1% were bacteremia and others (6.9%) were fungemia. As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6% to 32.5%), Escherichia coli (9.8% to 13.6%) and Klebsiella pneumonia (5.3% to 10.4%) had been dynamic increased (time trends P <0.05) and the proportion of Pseudomonas aeruginosa had dynamic decreased (4.0% to 2.4%, time trend P =0.007). However, Staphylococcus aureus (3.3% to 3.1%) and Acinetobacter baumannii (4.4% to 4.2%) had not changed significantly (time trend P >0.05). These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. Additionally, among bacteremia, the proportion of the multidrug-resistant bacteria gradually increased from 52.9% to 68.4% (time trend P <0.001). Conclusion The incidence rate and the species distribution had been dynamic changing and this study could be supplements to the 2018 CHINET report.

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“…Prior evidence suggests sex-related risk differences for developing sepsis. However, the prognostic effect of sex on sepsis outcomes remains uncertain, as previous studies reported inconsistent ndings [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the role of sex as a prognostic factor in critically ill adults with sepsis: a systematic review and meta-analysis

Antequera

López‐Alcalde

Stallings

et al. 2020

Preprint

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Background: Incidence and sepsis-related mortality are failing, but sepsis continues to be a leading cause of admission and death in intensive care units (ICUs). Although the preceding evidence suggests sex-related risk differences for developing sepsis, the influence of sex on mortality outcomes remains unclear as previous studies showed discordant results. This systematic review assesed the independent effect of sex for mortality among critically ill patients with sepsis.Methods: Electronic databases were searched up to 17th July 2020 for studies that examined independent associations between sex and mortality outcomes in critically ill adults with sepsis while controlling for covariates. Primary meta-analyses were performed by pooling adjusted estimates for a pre-specified core set of adjustment factors. The primary outcomes included all-cause hospital mortality and 28-day all-cause hospital mortality. The secondary outcomes included 7-day all-cause hospital mortality, 1-year all-cause mortality, and all-cause ICU mortality.Results: Among the 14304 records identified, 12 studies (71850 participants) were included. Meta-analysis showed inconclusive results on sex-based differences in hospital mortality (OR 0.95, 95% CI 0.55 to 1.64; very low-certainty evidence) and ICU mortality (OR 1.19, 95% CI 0.79 to 1.78; very low-certainty evidence). Meta-analysis found higher 28-day hospital mortality in the female group (OR 1.18, 95% CI 1.05 to 1.32; very low-certainty evidence). No studies reported on 7-day hospital mortality. A single study provided adjusted estimates on 1-year mortality reporting lower risk in the female group (OR 0.83 95% CI 0.68 to 0.98; low-certainty of evidence). The main reasons for assessing the certainty of evidence as very low were inconsistency and imprecision while downgrading to low-certainty was risk of bias and imprecision.Conclusions: The prognostic independent effect of sex on hospital mortality, 28-day hospital mortality, and ICU mortality for critically ill adults with sepsis is uncertain. Female sex may be associated with decreased 1-year mortality. No included studies reported on 7-day all-cause hospital mortality.

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Community-onset sepsis and its public health burden: a systematic review

Cited by 29 publications

References 67 publications

Evidence of High Mortality and Increasing Burden of Sepsis in a Regional Sample of the New Zealand Population

Evidence of High Mortality and Increasing Burden of Sepsis in a Regional Sample of the New Zealand Population

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

Evaluation of the role of sex as a prognostic factor in critically ill adults with sepsis: a systematic review and meta-analysis

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