Positive Culture and Prognosis in Patients With Sepsis: A Prospective Cohort Study.
Autor: Molina, Fernando; Castaño, Pablo; Plaza, Maribel; Hincapié, Carolina; Maya, Wilmar; Cataño, Juan Carlos; González, Javier; León, Alba; Jaimes, Fabián
Publication year: 2020
Journal of intensive care medicine
issn:1525-1489 0885-0666
doi: 10.1177/0885066618783656
Abstract:
PURPOSE: To analyze the prognostic role of positive cultures in patients with sepsis. METHODS: A prospective cohort study in a tertiary referral hospital in Medellín, Colombia. Adults older than 18 years of age with a bacterial infection diagnosis according to Centers for Disease Control criteria and sepsis (evidence of organ dysfunction) were included. A logistic regression model was used to determine the association between positive cultures and hospital mortality, and a Cox regression with a competing risk modeling approach was used to determine the association between positive cultures and hospital stay as well as secondary infections. RESULTS: Overall, 408 patients had positive cultures, of which 257 were blood culture, and 153 had negative cultures. Patients with positive cultures had a lower risk of mortality (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.27-0.68), but this association was not maintained after adjusting for confounding factors (OR, 0.56; 95% CI, 0.31-1.01). No association was found with the hospital stay (adjusted subhazard ratio [SHR], 1.06; 95% CI, 0.83-1.35). There was no association between positive cultures and the presence of secondary infections (adjusted SHR, 0.99; 95% CI, 0.58-1.71). CONCLUSION: Positive cultures are not associated with prognosis in patients with sepsis.
Language: eng
Rights:
Pmid: 29925284
Tags: Humans; Aged; Female; Male; Prospective Studies; Middle Aged; Prognosis; Risk Factors; epidemiology; Colombia; Risk Assessment; Logistic Models; Odds Ratio; Tertiary Care Centers; Length of Stay/statistics & numerical data; *Hospital Mortality; Critical Care Outcomes; mortality; sepsis; Proportional Hazards Models; Bacterial Infections/microbiology/*mortality; Bacteriological Techniques/*statistics & numerical data; blood culture; microbiological culture; Sepsis/microbiology/*mortality
Link: https://pubmed.ncbi.nlm.nih.gov/29925284/
