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Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study

BACKGROUND: We evaluated the characteristics and outcomes of culture-negative versus culture-positive septic shock. METHODS: We performed a retrospective observational study of data from a prospective registry from 2014 to 2018. A total of 2,499 adult patients with septic shock were enrolled. The pr...

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Autores principales: Kim, June-sung, Kim, Youn-Jung, Kim, Won Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787242/
https://www.ncbi.nlm.nih.gov/pubmed/33407768
http://dx.doi.org/10.1186/s13054-020-03421-4
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author Kim, June-sung
Kim, Youn-Jung
Kim, Won Young
author_facet Kim, June-sung
Kim, Youn-Jung
Kim, Won Young
author_sort Kim, June-sung
collection PubMed
description BACKGROUND: We evaluated the characteristics and outcomes of culture-negative versus culture-positive septic shock. METHODS: We performed a retrospective observational study of data from a prospective registry from 2014 to 2018. A total of 2,499 adult patients with septic shock were enrolled. The primary outcome was 90-day mortality, and the secondary outcomes were the length of hospital stay, a requirement for mechanical ventilation or renal replacement therapy, and in-hospital mortality. RESULTS: Of 1,718 patients with septic shock, 1,012 (58.9%) patients were culture-positive (blood 803, urine 302, sputum 102, others 204) and the median pathogen detection time was 9.5 h (aerobic 10.2 h and anaerobic 9.0 h). The most common site of culture-positive infection was the hepatobiliary tract (39.5%), while for the culture-negative it was the lower respiratory tract (38.2%). The culture-negative group had a lower mean body temperature (37.3 vs 37.7 ℃), lactate (2.5 vs. 3.2 mmol/L), C-reactive protein (11.1 vs 11.9 mg/dL), and sequential organ failure assessment score (7.0 vs. 8.0) than that of the culture-positive group. However, 90-day mortality between the groups was not significantly different (32.7 vs 32.2%, p = 0.83), and the other clinical outcomes also did not differ significantly. Moreover, a shorter culture detection time was correlated with a higher sequential organ failure assessment score but not with mortality. CONCLUSION: Patients with septic shock are frequently culture-negative, especially in cases where the infection focus is in the lower respiratory tract. Although culture-negative was associated with a degree of organ dysfunction, it was not an independent predictor of death.
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spelling pubmed-77872422021-01-07 Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study Kim, June-sung Kim, Youn-Jung Kim, Won Young Crit Care Research BACKGROUND: We evaluated the characteristics and outcomes of culture-negative versus culture-positive septic shock. METHODS: We performed a retrospective observational study of data from a prospective registry from 2014 to 2018. A total of 2,499 adult patients with septic shock were enrolled. The primary outcome was 90-day mortality, and the secondary outcomes were the length of hospital stay, a requirement for mechanical ventilation or renal replacement therapy, and in-hospital mortality. RESULTS: Of 1,718 patients with septic shock, 1,012 (58.9%) patients were culture-positive (blood 803, urine 302, sputum 102, others 204) and the median pathogen detection time was 9.5 h (aerobic 10.2 h and anaerobic 9.0 h). The most common site of culture-positive infection was the hepatobiliary tract (39.5%), while for the culture-negative it was the lower respiratory tract (38.2%). The culture-negative group had a lower mean body temperature (37.3 vs 37.7 ℃), lactate (2.5 vs. 3.2 mmol/L), C-reactive protein (11.1 vs 11.9 mg/dL), and sequential organ failure assessment score (7.0 vs. 8.0) than that of the culture-positive group. However, 90-day mortality between the groups was not significantly different (32.7 vs 32.2%, p = 0.83), and the other clinical outcomes also did not differ significantly. Moreover, a shorter culture detection time was correlated with a higher sequential organ failure assessment score but not with mortality. CONCLUSION: Patients with septic shock are frequently culture-negative, especially in cases where the infection focus is in the lower respiratory tract. Although culture-negative was associated with a degree of organ dysfunction, it was not an independent predictor of death. BioMed Central 2021-01-06 /pmc/articles/PMC7787242/ /pubmed/33407768 http://dx.doi.org/10.1186/s13054-020-03421-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kim, June-sung
Kim, Youn-Jung
Kim, Won Young
Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title_full Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title_fullStr Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title_full_unstemmed Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title_short Characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
title_sort characteristics and clinical outcomes of culture-negative and culture-positive septic shock: a single-center retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787242/
https://www.ncbi.nlm.nih.gov/pubmed/33407768
http://dx.doi.org/10.1186/s13054-020-03421-4
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