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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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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. |
format | Online Article Text |
id | pubmed-7787242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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