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Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia

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Author(s)
Cheol-In KangJae-Hoon SongDoo Ryeon ChungKyong Ran PeckKwan Soo KoJoon-Sup YeomHyun Kyun KiJun Seong SonSeung Soon LeeYeon-Sook KimSook-In JungShin-Woo KimHyun-Ha ChangSeong Yeol RyuKi Tae KwonHyuck LeeChisook Moon
Keimyung Author(s)
Ryu, Seong Yeol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Infection
Issued Date
2011
Volume
62
Issue
1
Keyword
Gram-negative bacterial infectionsBacteremiaSepsisRisk factorsTreatment outcome
Abstract
Background:
The aim of this study was to identify risk factors for development of severe sepsis or septic shock and to evaluate the clinical impact of severe sepsis on outcome in patients with gram-negative bacteremia (GNB).
Methods:
From the database of a nationwide surveillance for bacteremia, patients with GNB were analyzed. Data of patients with severe sepsis or septic shock were compared with those of patient with sepsis.
Results:
Of 2286 patients with GNB, 506 (22.1%) fulfilled the criteria of severe sepsis or septic shock. Factors associated with severe sepsis or septic shock in the multivariate analysis included renal disease, indwelling urinary catheter, hematologic malignancy, and neutropenia. The 30-day mortality of patients with severe sepsis or septic shock was significantly higher than that of patients with sepsis (39.5% [172/435] vs. 7.4% [86/1170]; P < 0.001). Multivariable analysis revealed that solid tumor, liver disease, pulmonary disease, pneumonia, and pathogens other than Escherichia coli, which were risk factors of development of severe sepsis or septic shock, were also found to be strong predictors of mortality. Severe sepsis or septic shock was a significant factor associated with mortality (OR, 3.34; 95% CI, 2.35–4.74), after adjustment for other variables predicting poor prognosis.
Conclusions:
Severe sepsis or septic shock was a common finding in patients with GNB, predicting a higher mortality rate. Renal disease and indwelling urinary catheter were the most important risk factors significantly associated with severe sepsis or septic shock among patients with GNB.
Keimyung Author(s)(Kor)
류성열
Publisher
School of Medicine
Citation
Cheol-In Kang et al. (2011). Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia. Journal of Infection, 62(1), 26–33. doi: 10.1016/j.jinf.2010.10.010
Type
Article
ISSN
0163-4453
Source
https://www.sciencedirect.com/science/article/pii/S0163445310003257?via%3Dihub
DOI
10.1016/j.jinf.2010.10.010
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33788
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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