TOPLINE:
Patients with nongenitourinary sepsis have the highest risk for intensive care unit (ICU) admission, prolonged hospital stay, and representation within 3 days post-discharge.
METHODOLOGY:
- This multicenter retrospective study evaluated 4109 patients with sepsis who presented to EDs in four Australian hospitals, with culture samples taken within 24 hours of triage.
- Researchers defined four culture positivity groups: bacteremic and urine culture-positive, bacteremic and urine culture-negative, nonbacteremic and urine culture-positive, and nonbacteremic and urine culture-negative (reference group).
- The study outcomes were in-hospital mortality, admission to the ICU, hospital length of stay, and representation to the ED within 3, 7, and 30 days post-discharge.
- Bacteremic, urine culture-negative patients had the highest risk for ICU admission (adjusted odds ratio [AOR], 1.60; 95% CI, 1.18-2.18) and representation to the ED within 3 days of discharge (AOR, 1.51; 95% CI, 1.02-2.25).
- Nonbacteremic, urine culture-positive patients had the lowest risk for ICU admission (AOR, 0.56; 95% CI, 0.41-0.76).
- Nonbacteremic, urine culture-positive patients had a longer average hospital stay (adjusted relative risk [ARR], 1.19; 95% CI, 1.04‐1.37) than the reference group, followed by the bacteremic, urine culture-negative patients (ARR, 1.17; 95% CI, 1.03-1.34).
- Antibiotic administration before sample collection was associated with a 62% lower likelihood of positive blood and urine culture results (AOR, 0.38; P <.0001).
IN PRACTICE:
"It is important to identify nongenitourinary sepsis cases as bacteremic urine culture-negative patients (BC+UC-) had a higher risk of ICU admission and prolonged hospital length of stay. It also emphasizes the importance of following up on blood and other culture results, checking antibiotic appropriateness, and undertaking closer monitoring of bacteremic patients with sepsis in hospital," the authors wrote.
SOURCE:
The study was led by Ling Li, Australian Institute of Health Innovation, Macquarie University in Sydney, Australia. It was published online on June 19, 2024, in Health Science Reports.
LIMITATIONS:
The study findings may not be generalizable to patients from other health settings. The study included only the two most common culture types, blood and urine. Potential unidentified confounders may have been missed due to the retrospective observational study design.
DISCLOSURES:
The authors did not provide any funding information. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.