Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study
Purpose To compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms. Materials and methods The medical records of 1581 adult patients who u...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2022-04, Vol.48 (2), p.963-971 |
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| creator | Sim, Joohyun Hong, Sung Soo Kwak, Jae Young Jung, Yun Tae |
| description | Purpose
To compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms.
Materials and methods
The medical records of 1581 adult patients who underwent emergency gastrointestinal surgery between January 2013 and December 2018 were reviewed retrospectively. A total of 239 patients with sepsis or septic shock who were admitted to an emergency department, underwent emergency surgery for cIAI, and needed postoperative intensive care unit care were included and divided into two groups according to their initial blood and peritoneal culture results.
Results
Among the 239 patients, 200 were culture-negative and 39 were culture-positive. The culture-positive group had higher in-hospital (35.9% vs 14.5%;
P
= .001) and 30-day mortality (30.8% vs 12.0%;
P
= .003) than the culture-negative group. Colon involvement (OR 4.211; 95% CI 1.909–9.287;
P
|
| doi_str_mv | 10.1007/s00068-020-01535-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7609359</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2649147167</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-7b34740355122a9c3ff2b438adb72c0d40b79021903c7deab2026f6d3536e4d33</originalsourceid><addsrcrecordid>eNp9kstu1TAQhiMEoqXwAiyQJTZsAr7FPmGBhCpuUiVYwNpy7Ek7lRMH2yk6b8Rj4nDK4bJgNWPPN79_29M0jxl9zijVLzKlVO1aymlLWSe6Vt1pTtlOibbvJbt7zIU4aR7kfF1pqjp-vzkRgslOMX3afP-UwKMrGGcSR-LWUNYE7RIzFrwBkmHJmImdfU0DHEGYFkzoaqHggLGgywRn4lJtczaEPcEQyGILwlwy-Yblirg4LaFWC_jKlmRbO_g44WxDXY8H8fySWJKgpJiXbWfzUFa_f9jcG23I8Og2njVf3r75fP6-vfj47sP564vWSS1LqwdRIxVdxzi3vRPjyAcpdtYPmjvqJR10TznrqXDagx045WpUXnRCgfRCnDWvDrrLOkzgHWxGg1kSTjbtTbRo_q7MeGUu443Rivai66vAs1uBFL-ukIuZMDsIwc4Q12y47LTaVYOqok__Qa_jmupzVErJnknNlK4UP1CuvklOMB7NMGq2QTCHQTB1EMzPQTCb9JM_r3Fs-fXzFRAHINfSfAnp99n_kf0BxjrDfg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2649147167</pqid></control><display><type>article</type><title>Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><creator>Sim, Joohyun ; Hong, Sung Soo ; Kwak, Jae Young ; Jung, Yun Tae</creator><creatorcontrib>Sim, Joohyun ; Hong, Sung Soo ; Kwak, Jae Young ; Jung, Yun Tae</creatorcontrib><description>Purpose
To compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms.
Materials and methods
The medical records of 1581 adult patients who underwent emergency gastrointestinal surgery between January 2013 and December 2018 were reviewed retrospectively. A total of 239 patients with sepsis or septic shock who were admitted to an emergency department, underwent emergency surgery for cIAI, and needed postoperative intensive care unit care were included and divided into two groups according to their initial blood and peritoneal culture results.
Results
Among the 239 patients, 200 were culture-negative and 39 were culture-positive. The culture-positive group had higher in-hospital (35.9% vs 14.5%;
P
= .001) and 30-day mortality (30.8% vs 12.0%;
P
= .003) than the culture-negative group. Colon involvement (OR 4.211; 95% CI 1.909–9.287;
P
< .001) and higher Sequential Organ Failure Assessment (SOFA) score (OR 1.169; 95% CI 1.065–1.282;
P
= .001) were shown to be the predictors of culture-positive sepsis for cIAI. Regarding antibiotic sensitivity, 31.6% of the gram-positive bacteria were methicillin-resistant and 42.1% of the gram-negative bacteria were extended spectrum β-lactamase-producing Enterobacteriaceae.
Conclusions
Patients with cIAI had higher mortality rates in culture-positive sepsis than in culture-negative sepsis. High SOFA score and colon involvement were the risk factors associated with culture-positivity. The most common single species grown in the blood or peritoneal cultures was
Escherichia coli
, and the most common group was Gram-positive cocci.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-020-01535-6</identifier><identifier>PMID: 33145617</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdomen ; Adult ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Critical Care Medicine ; Critical Illness ; Emergency medical care ; Emergency Medicine ; Gram-positive bacteria ; Humans ; Infections ; Intensive ; Intraabdominal Infections - drug therapy ; Medicine ; Medicine & Public Health ; Mortality ; Original ; Original Article ; Retrospective Studies ; Sepsis ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2022-04, Vol.48 (2), p.963-971</ispartof><rights>The Author(s) 2020</rights><rights>2020. The Author(s).</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-7b34740355122a9c3ff2b438adb72c0d40b79021903c7deab2026f6d3536e4d33</citedby><cites>FETCH-LOGICAL-c474t-7b34740355122a9c3ff2b438adb72c0d40b79021903c7deab2026f6d3536e4d33</cites><orcidid>0000-0002-2926-3862 ; 0000-0001-8263-2260 ; 0000-0002-3583-7105</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-020-01535-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-020-01535-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33145617$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sim, Joohyun</creatorcontrib><creatorcontrib>Hong, Sung Soo</creatorcontrib><creatorcontrib>Kwak, Jae Young</creatorcontrib><creatorcontrib>Jung, Yun Tae</creatorcontrib><title>Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Purpose
To compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms.
Materials and methods
The medical records of 1581 adult patients who underwent emergency gastrointestinal surgery between January 2013 and December 2018 were reviewed retrospectively. A total of 239 patients with sepsis or septic shock who were admitted to an emergency department, underwent emergency surgery for cIAI, and needed postoperative intensive care unit care were included and divided into two groups according to their initial blood and peritoneal culture results.
Results
Among the 239 patients, 200 were culture-negative and 39 were culture-positive. The culture-positive group had higher in-hospital (35.9% vs 14.5%;
P
= .001) and 30-day mortality (30.8% vs 12.0%;
P
= .003) than the culture-negative group. Colon involvement (OR 4.211; 95% CI 1.909–9.287;
P
< .001) and higher Sequential Organ Failure Assessment (SOFA) score (OR 1.169; 95% CI 1.065–1.282;
P
= .001) were shown to be the predictors of culture-positive sepsis for cIAI. Regarding antibiotic sensitivity, 31.6% of the gram-positive bacteria were methicillin-resistant and 42.1% of the gram-negative bacteria were extended spectrum β-lactamase-producing Enterobacteriaceae.
Conclusions
Patients with cIAI had higher mortality rates in culture-positive sepsis than in culture-negative sepsis. High SOFA score and colon involvement were the risk factors associated with culture-positivity. The most common single species grown in the blood or peritoneal cultures was
Escherichia coli
, and the most common group was Gram-positive cocci.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Critical Care Medicine</subject><subject>Critical Illness</subject><subject>Emergency medical care</subject><subject>Emergency Medicine</subject><subject>Gram-positive bacteria</subject><subject>Humans</subject><subject>Infections</subject><subject>Intensive</subject><subject>Intraabdominal Infections - drug therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kstu1TAQhiMEoqXwAiyQJTZsAr7FPmGBhCpuUiVYwNpy7Ek7lRMH2yk6b8Rj4nDK4bJgNWPPN79_29M0jxl9zijVLzKlVO1aymlLWSe6Vt1pTtlOibbvJbt7zIU4aR7kfF1pqjp-vzkRgslOMX3afP-UwKMrGGcSR-LWUNYE7RIzFrwBkmHJmImdfU0DHEGYFkzoaqHggLGgywRn4lJtczaEPcEQyGILwlwy-Yblirg4LaFWC_jKlmRbO_g44WxDXY8H8fySWJKgpJiXbWfzUFa_f9jcG23I8Og2njVf3r75fP6-vfj47sP564vWSS1LqwdRIxVdxzi3vRPjyAcpdtYPmjvqJR10TznrqXDagx045WpUXnRCgfRCnDWvDrrLOkzgHWxGg1kSTjbtTbRo_q7MeGUu443Rivai66vAs1uBFL-ukIuZMDsIwc4Q12y47LTaVYOqok__Qa_jmupzVErJnknNlK4UP1CuvklOMB7NMGq2QTCHQTB1EMzPQTCb9JM_r3Fs-fXzFRAHINfSfAnp99n_kf0BxjrDfg</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Sim, Joohyun</creator><creator>Hong, Sung Soo</creator><creator>Kwak, Jae Young</creator><creator>Jung, Yun Tae</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2926-3862</orcidid><orcidid>https://orcid.org/0000-0001-8263-2260</orcidid><orcidid>https://orcid.org/0000-0002-3583-7105</orcidid></search><sort><creationdate>20220401</creationdate><title>Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study</title><author>Sim, Joohyun ; Hong, Sung Soo ; Kwak, Jae Young ; Jung, Yun Tae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-7b34740355122a9c3ff2b438adb72c0d40b79021903c7deab2026f6d3536e4d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Critical Care Medicine</topic><topic>Critical Illness</topic><topic>Emergency medical care</topic><topic>Emergency Medicine</topic><topic>Gram-positive bacteria</topic><topic>Humans</topic><topic>Infections</topic><topic>Intensive</topic><topic>Intraabdominal Infections - drug therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sim, Joohyun</creatorcontrib><creatorcontrib>Hong, Sung Soo</creatorcontrib><creatorcontrib>Kwak, Jae Young</creatorcontrib><creatorcontrib>Jung, Yun Tae</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sim, Joohyun</au><au>Hong, Sung Soo</au><au>Kwak, Jae Young</au><au>Jung, Yun Tae</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>48</volume><issue>2</issue><spage>963</spage><epage>971</epage><pages>963-971</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Purpose
To compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms.
Materials and methods
The medical records of 1581 adult patients who underwent emergency gastrointestinal surgery between January 2013 and December 2018 were reviewed retrospectively. A total of 239 patients with sepsis or septic shock who were admitted to an emergency department, underwent emergency surgery for cIAI, and needed postoperative intensive care unit care were included and divided into two groups according to their initial blood and peritoneal culture results.
Results
Among the 239 patients, 200 were culture-negative and 39 were culture-positive. The culture-positive group had higher in-hospital (35.9% vs 14.5%;
P
= .001) and 30-day mortality (30.8% vs 12.0%;
P
= .003) than the culture-negative group. Colon involvement (OR 4.211; 95% CI 1.909–9.287;
P
< .001) and higher Sequential Organ Failure Assessment (SOFA) score (OR 1.169; 95% CI 1.065–1.282;
P
= .001) were shown to be the predictors of culture-positive sepsis for cIAI. Regarding antibiotic sensitivity, 31.6% of the gram-positive bacteria were methicillin-resistant and 42.1% of the gram-negative bacteria were extended spectrum β-lactamase-producing Enterobacteriaceae.
Conclusions
Patients with cIAI had higher mortality rates in culture-positive sepsis than in culture-negative sepsis. High SOFA score and colon involvement were the risk factors associated with culture-positivity. The most common single species grown in the blood or peritoneal cultures was
Escherichia coli
, and the most common group was Gram-positive cocci.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33145617</pmid><doi>10.1007/s00068-020-01535-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2926-3862</orcidid><orcidid>https://orcid.org/0000-0001-8263-2260</orcidid><orcidid>https://orcid.org/0000-0002-3583-7105</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1863-9933 1863-9941 |
| language | eng |
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| source | MEDLINE; SpringerLink (Online service) |
| subjects | Abdomen Adult Anti-Bacterial Agents - therapeutic use Antibiotics Critical Care Medicine Critical Illness Emergency medical care Emergency Medicine Gram-positive bacteria Humans Infections Intensive Intraabdominal Infections - drug therapy Medicine Medicine & Public Health Mortality Original Original Article Retrospective Studies Sepsis Sports Medicine Surgery Surgical Orthopedics Traumatic Surgery |
| title | Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study |
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