Cargando…

Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study

Introduction: To evaluate the prognostic value of the time-to-positivity in patients with culture-positive septic shock. Methods: Retrospective study using a prospective data registry was performed at the emergency department of a tertiary hospital. Consecutive adult patients with septic shock (N =...

Descripción completa

Detalles Bibliográficos
Autores principales: Bae, Hong-Jun, Kim, June-sung, Kim, Muyeol, Kim, Youn-Jung, Kim, Won Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228862/
https://www.ncbi.nlm.nih.gov/pubmed/34201159
http://dx.doi.org/10.3390/antibiotics10060683
_version_ 1783712841583296512
author Bae, Hong-Jun
Kim, June-sung
Kim, Muyeol
Kim, Youn-Jung
Kim, Won Young
author_facet Bae, Hong-Jun
Kim, June-sung
Kim, Muyeol
Kim, Youn-Jung
Kim, Won Young
author_sort Bae, Hong-Jun
collection PubMed
description Introduction: To evaluate the prognostic value of the time-to-positivity in patients with culture-positive septic shock. Methods: Retrospective study using a prospective data registry was performed at the emergency department of a tertiary hospital. Consecutive adult patients with septic shock (N = 2499) were enrolled between 2014 and 2018. Bacteremia was defined using blood cultures, and viral and fungal pathogens were excluded. The primary outcome was the 28-day mortality. Results: In 803 (46.7%) septic shock patients with bacteremia, median TTP was 10.1 h. The most prevalent isolated bacterial pathogens were Escherichia coli (40.8%) and Klebsiella (23.4%). Although the TTP correlated with a higher sequential organ failure assessment score (Spearman’s rho = −0.12, p < 0.01), it showed no significant difference between the 28-day survivors and non-survivors (10.2 vs. 9.4 days, p = 0.35). In subgroup analysis of the Escherichia coli and Klebsiella bacteremia cases, a shorter TTP showed prognostic value for predicting the 28-day mortality. The optimal TTP cut-off for Escherichia coli and Klebsiella was 10 h and 8 h, respectively. Conclusions: The prognostic value of the TTP in septic shock patients receiving bundle therapy may be limited and its clinical interpretation should only be made on a pathogen-specific basis.
format Online
Article
Text
id pubmed-8228862
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-82288622021-06-26 Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study Bae, Hong-Jun Kim, June-sung Kim, Muyeol Kim, Youn-Jung Kim, Won Young Antibiotics (Basel) Article Introduction: To evaluate the prognostic value of the time-to-positivity in patients with culture-positive septic shock. Methods: Retrospective study using a prospective data registry was performed at the emergency department of a tertiary hospital. Consecutive adult patients with septic shock (N = 2499) were enrolled between 2014 and 2018. Bacteremia was defined using blood cultures, and viral and fungal pathogens were excluded. The primary outcome was the 28-day mortality. Results: In 803 (46.7%) septic shock patients with bacteremia, median TTP was 10.1 h. The most prevalent isolated bacterial pathogens were Escherichia coli (40.8%) and Klebsiella (23.4%). Although the TTP correlated with a higher sequential organ failure assessment score (Spearman’s rho = −0.12, p < 0.01), it showed no significant difference between the 28-day survivors and non-survivors (10.2 vs. 9.4 days, p = 0.35). In subgroup analysis of the Escherichia coli and Klebsiella bacteremia cases, a shorter TTP showed prognostic value for predicting the 28-day mortality. The optimal TTP cut-off for Escherichia coli and Klebsiella was 10 h and 8 h, respectively. Conclusions: The prognostic value of the TTP in septic shock patients receiving bundle therapy may be limited and its clinical interpretation should only be made on a pathogen-specific basis. MDPI 2021-06-08 /pmc/articles/PMC8228862/ /pubmed/34201159 http://dx.doi.org/10.3390/antibiotics10060683 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bae, Hong-Jun
Kim, June-sung
Kim, Muyeol
Kim, Youn-Jung
Kim, Won Young
Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title_full Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title_fullStr Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title_full_unstemmed Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title_short Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study
title_sort prognostic value of the time-to-positivity in blood cultures from septic shock patients with bacteremia receiving protocol-driven resuscitation bundle therapy: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228862/
https://www.ncbi.nlm.nih.gov/pubmed/34201159
http://dx.doi.org/10.3390/antibiotics10060683
work_keys_str_mv AT baehongjun prognosticvalueofthetimetopositivityinbloodculturesfromsepticshockpatientswithbacteremiareceivingprotocoldrivenresuscitationbundletherapyaretrospectivecohortstudy
AT kimjunesung prognosticvalueofthetimetopositivityinbloodculturesfromsepticshockpatientswithbacteremiareceivingprotocoldrivenresuscitationbundletherapyaretrospectivecohortstudy
AT kimmuyeol prognosticvalueofthetimetopositivityinbloodculturesfromsepticshockpatientswithbacteremiareceivingprotocoldrivenresuscitationbundletherapyaretrospectivecohortstudy
AT kimyounjung prognosticvalueofthetimetopositivityinbloodculturesfromsepticshockpatientswithbacteremiareceivingprotocoldrivenresuscitationbundletherapyaretrospectivecohortstudy
AT kimwonyoung prognosticvalueofthetimetopositivityinbloodculturesfromsepticshockpatientswithbacteremiareceivingprotocoldrivenresuscitationbundletherapyaretrospectivecohortstudy