Prognostic factors of community-acquired bacteremic patients with severe sepsis

A prospective, observational study

Young Kyung Yoon, Min Ja Kim, Dae Won Park, Soon Sun Kwon, Byung Chul Chun, Hee Jin Cheong, JunYong Choi, Hee Jung Choi, Young Hwa Choi, Hyo Youl Kim, Joong Sik Eom, Sang Il Kim, Young Goo Song, Kyong Ran Peck, Yang Soo Kim, June Myung Kim, Jang Wook Sohn

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality. Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.

Original languageEnglish
Pages (from-to)168-174
Number of pages7
JournalInfection and Chemotherapy
Volume44
Issue number3
DOIs
Publication statusPublished - 2012 Jun 1

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Observational Studies
Sepsis
Prospective Studies
Odds Ratio
Confidence Intervals
APACHE
Mortality
Infection
Teaching Hospitals
Respiratory Tract Infections
Shock
Hospitalization
Demography
Escherichia coli
Anti-Bacterial Agents
Survival

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Yoon, Y. K., Kim, M. J., Park, D. W., Kwon, S. S., Chun, B. C., Cheong, H. J., ... Sohn, J. W. (2012). Prognostic factors of community-acquired bacteremic patients with severe sepsis: A prospective, observational study. Infection and Chemotherapy, 44(3), 168-174. https://doi.org/10.3947/ic.2012.44.3.168
Yoon, Young Kyung ; Kim, Min Ja ; Park, Dae Won ; Kwon, Soon Sun ; Chun, Byung Chul ; Cheong, Hee Jin ; Choi, JunYong ; Choi, Hee Jung ; Choi, Young Hwa ; Kim, Hyo Youl ; Eom, Joong Sik ; Kim, Sang Il ; Song, Young Goo ; Peck, Kyong Ran ; Kim, Yang Soo ; Kim, June Myung ; Sohn, Jang Wook. / Prognostic factors of community-acquired bacteremic patients with severe sepsis : A prospective, observational study. In: Infection and Chemotherapy. 2012 ; Vol. 44, No. 3. pp. 168-174.
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abstract = "Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0{\%}) patients went into shock and 121 patients (28.7{\%}) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95{\%} confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95{\%} CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95{\%} CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95{\%} CI, 0.16-0.64) showed an association with lower mortality. Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.",
author = "Yoon, {Young Kyung} and Kim, {Min Ja} and Park, {Dae Won} and Kwon, {Soon Sun} and Chun, {Byung Chul} and Cheong, {Hee Jin} and JunYong Choi and Choi, {Hee Jung} and Choi, {Young Hwa} and Kim, {Hyo Youl} and Eom, {Joong Sik} and Kim, {Sang Il} and Song, {Young Goo} and Peck, {Kyong Ran} and Kim, {Yang Soo} and Kim, {June Myung} and Sohn, {Jang Wook}",
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Yoon, YK, Kim, MJ, Park, DW, Kwon, SS, Chun, BC, Cheong, HJ, Choi, J, Choi, HJ, Choi, YH, Kim, HY, Eom, JS, Kim, SI, Song, YG, Peck, KR, Kim, YS, Kim, JM & Sohn, JW 2012, 'Prognostic factors of community-acquired bacteremic patients with severe sepsis: A prospective, observational study', Infection and Chemotherapy, vol. 44, no. 3, pp. 168-174. https://doi.org/10.3947/ic.2012.44.3.168

Prognostic factors of community-acquired bacteremic patients with severe sepsis : A prospective, observational study. / Yoon, Young Kyung; Kim, Min Ja; Park, Dae Won; Kwon, Soon Sun; Chun, Byung Chul; Cheong, Hee Jin; Choi, JunYong; Choi, Hee Jung; Choi, Young Hwa; Kim, Hyo Youl; Eom, Joong Sik; Kim, Sang Il; Song, Young Goo; Peck, Kyong Ran; Kim, Yang Soo; Kim, June Myung; Sohn, Jang Wook.

In: Infection and Chemotherapy, Vol. 44, No. 3, 01.06.2012, p. 168-174.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic factors of community-acquired bacteremic patients with severe sepsis

T2 - A prospective, observational study

AU - Yoon, Young Kyung

AU - Kim, Min Ja

AU - Park, Dae Won

AU - Kwon, Soon Sun

AU - Chun, Byung Chul

AU - Cheong, Hee Jin

AU - Choi, JunYong

AU - Choi, Hee Jung

AU - Choi, Young Hwa

AU - Kim, Hyo Youl

AU - Eom, Joong Sik

AU - Kim, Sang Il

AU - Song, Young Goo

AU - Peck, Kyong Ran

AU - Kim, Yang Soo

AU - Kim, June Myung

AU - Sohn, Jang Wook

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality. Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.

AB - Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality. Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.

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