Positive Culture and Prognosis in Patients With Sepsis: A Prospective Cohort Study

Molina, Fernando; Castaño, Pablo; Plaza, Maribel; Hincapié, Carolina; Maya, Wilmar; Cataño, Juan Carlos; González, Javier Martı́nez; León, Alba; Jaimes, Fabián

doi:10.1177/0885066618783656

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…The findings of Marco et al were similar to ours, and mortality did not increase with a positive test result for bacteraemia 25 . In another prospective cohort study, positive blood cultures were not associated with outcomes in patients with sepsis 31 . A recent meta-analysis also showed that positive or negative blood cultures were not associated with mortality in patients suffering fromsepsis 32 .…”

Section: Discussionmentioning

confidence: 93%

Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection

Zhou

Wen

Mao

et al. 2023

Sci Rep

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The application of metagenomic next-generation sequencing (mNGS) has gradually been carried out by clinical practitioner. However, few studies have compared it with blood cultures in patients suffering from suspected bloodstream infections. The purpose of this study was to compare the detection of pathogenic microorganisms by these two assays in patients with suspected bloodstream infection. We retrospectively studied patients with fever, chills, antibiotic use for more than 3 days, suspected bloodstream infection, and admission to the emergency department of Ruijin Hospital from January 2020 to June 2022. All patients had blood drawn on the same day for blood mNGS and blood cultures. Clinical and laboratory parameters were collected on the day blood was drawn. The detection of pathogenic microorganisms by the two methods was compared. Risk factors and in-hospital mortality in patients with bloodstream infections were analysed separately for these two assays. In all 99 patients, the pathogenic microorganisms detection rate in blood mNGS was significantly higher than that in blood culture. Blood mNGS was consistent with blood culture in only 12.00% of all positive bacterial and fungal test results. The level of CRP is related to bacteraemia, fungaemia and viraemia detected by blood mNGS. No clear risk factors could be found in patients with a positive blood culture. In critically ill patients, both tests failed to improve patient outcomes. In patients with suspected bloodstream infection, mNGS is not yet a complete replacement for blood cultures.

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Section: Discussionmentioning

confidence: 93%

Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection

Zhou

Wen

Mao

et al. 2023

Sci Rep

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“…( 29,30 ) Similarly, it has been described that patients with sepsis without focus and negative cultures have lower mortality than patients with positive cultures; ( 31 ) however, our findings, which we have corroborated in another recently published study, did not agree with this statement. ( 32 )…”

Section: Discussionmentioning

confidence: 99%

Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia

Caraballo¹,

Ascuntar²,

Hincapié³

et al. 2019

Revista Brasileira De Terapia Intensiva

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Objective To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department. Methods This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality. Results The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p < 0.001), skin and soft tissues (OR 2.6; 95%CI, 1.4 - 5.0; p = 0.003), bloodstream (OR 2.0; 95%CI, 1.1 - 3.6; p = 0.018), without specific focus (OR 2.0; 95%CI, 1.1 - 3.8; p = 0.028), and intra-abdominal focus (OR 1.9; 95%CI, 1.1 - 3.3; p = 0.024). Conclusions There is a significant association between the different sites of infection and in-hospital mortality or the need for admission to an intensive care unit in patients with sepsis or septic shock. Urinary tract infection shows the lowest risk, which should be considered in prognostic models of these conditions.

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“…Apart from the above understanding of the pathogenesis of sepsis, several treatment methods have been established for sepsis patients including antibiotics, hemodynamic management, infection source control, etc. ; however, their mortality risk remains high 8‐12 . Thus, it is helpful to explore potential biomarkers for sepsis, based on which clinicians could manage patients timely to improve their prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…; however, their mortality risk remains high. 8 , 9 , 10 , 11 , 12 Thus, it is helpful to explore potential biomarkers for sepsis, based on which clinicians could manage patients timely to improve their prognosis.…”

Section: Introductionmentioning

confidence: 99%

Blood long non‐coding RNA intersectin 1–2 is highly expressed and links with increased Th17 cells, inflammation, multiple organ dysfunction, and mortality risk in sepsis patients

Huang

Wang

2022

Clinical Laboratory Analysis

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Background Long non‐coding RNA intersectin 1–2 (lnc‐ITSN1‐2) exacerbates inflammation and promotes T‐helper (Th) cell differentiation, also serves as a biomarker in critical illness diseases. However, its clinical role in sepsis remains obscure. Hence, the study aimed to explore the relationship of lnc‐ITSN1‐2 with Th cells, inflammation, disease severity, multiple organ dysfunction, and mortality risk in sepsis. Methods Peripheral blood mononuclear cells (PBMC) were isolated from 95 sepsis patients and 50 health controls, followed by lnc‐ITSN1‐2 evaluation using RT‐qPCR. PBMC Th1, Th17 cells and their secreted cytokines in serum were detected by flow cytometry and ELISA, respectively. Results Lnc‐ITSN1‐2 in sepsis patients was higher than it in health controls (Z = −7.328, p < 0.001). Lnc‐ITSN1‐2 correlated with increased interferon‐gamma (p = 0.009), Th17 cells (p = 0.022), and interleukin‐17A (p = 0.006), but not Th1 cells (p = 0.169) in sepsis patients. Moreover, lnc‐ITSN1‐2 had a positive connection with C‐reactive protein (p = 0.001), acute pathologic and chronic health evaluation (APACHE) II (p = 0.024), and sequential organ failure assessment (SOFA) scores (p = 0.022). Regarding SOFA subscales, lnc‐ITSN1‐2 linked with elevated respiratory system score (p = 0.005), cardiovascular system score (p = 0.007), and renal system score (p = 0.004) but no other subscales. Besides, lnc‐ITSN1‐2 had an increasing trend, but no statistical difference, in septic deaths compared to survivors (Z = −1.852, p = 0.064). Conclusion Lnc‐ITSN1‐2 reflects sepsis progression and unfavorable prognosis to some extent, which may serve as a potential biomarker to improve the management of sepsis patients.

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Positive Culture and Prognosis in Patients With Sepsis: A Prospective Cohort Study

Cited by 4 publications

References 23 publications

Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection

Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection

Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia

Blood long non‐coding RNA intersectin 1–2 is highly expressed and links with increased Th17 cells, inflammation, multiple organ dysfunction, and mortality risk in sepsis patients

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