Comparison of Clinical Outcomes Between Culture-Positive and Culture-Negative Sepsis and Septic Shock Patients: A Meta-Analysis

Abstract

This meta-analysis has been conducted to compare the clinical outcomes between culture-positive and culture-negative sepsis or septic patients. The present meta-analysis is reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed and EMBASE, were searched by two authors independently from the inception to January 25, 2023, using the following key terms: "culture positive," "culture negative," "sepsis," and "septic shock." The primary outcome assessed in the present meta-analysis was all-cause mortality. Secondary outcomes included the need for mechanical ventilation, renal replacement therapy, length of ICU stay in days, and length of hospital stay in days. Total 10 studies met the inclusion criteria and were included in the metaanalysis involving 23,973 patients. No statistically significant difference was found between culture-positive and culture-negative patients in terms of all-cause mortality (risk ratio [

Fever and Hypotension Vs. Frank Septic Shock: Elderly Patients Taking Vasodilators Who Present with Fever and Hypotension Have a Higher Incidence of Negative Blood Cultures. A Retrospective Analysis of 3,726 Patients.

“…They did not characterize the culture-negative patients regarding chronic use of medications (23). In their metanalysis of 10 studies, involving almost 24,000 patients, Afzai et al compared the clinical outcomes of culturepositive vs. culture-negative patients and found that there were no signi cant differences in all-cause mortality, need for mechanical ventilation, hemodialysis and length of ICU stay (24). They did not address potential etiologies for hypotension amongst their culture-negative patients as well, and therefore, it could be argued that other causes for deterioration enhanced the death of patients whose cultures turned to be negative.…”