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Rhabdomyolysis in community acquired bacterial sepsis--a retrospective cohort study

Anita A Kumar1, Emmanuel Bhaskar, Ghanshyam Palamaner Subash Shantha

  • 1Department of General Medicine, Sri Ramachandra University, Tamilnadu, Chennai, India.

Plos One
|September 30, 2009
PubMed
Abstract

Insights

Gram-negative bacteria, not gram-positive, were more often linked to sepsis-induced rhabdomyolysis in this South Indian study. This condition is multifactorial and carries a high mortality rate.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Critical Care Medicine

Background:

  • Sepsis-induced rhabdomyolysis is a serious complication, often attributed to gram-positive bacteria.
  • Understanding the specific bacterial pathogens and contributing factors in diverse populations is crucial for effective management.

Purpose of the Study:

  • To investigate the pattern of bacterial pathogens causing sepsis-associated rhabdomyolysis.
  • To identify associated causal factors and mortality in a South-Indian cohort.

Main Methods:

  • Retrospective cohort study of adult patients with community-acquired bacterial sepsis and rhabdomyolysis (serum creatine kinase >2000 IU/L).
  • Patients were categorized into groups based on gram-positive, gram-negative, or culture-negative sepsis.
  • Data on demographics, comorbidities, causative pathogens, and additional rhabdomyolysis risk factors were analyzed.

Main Results:

  • Gram-negative pathogens (33%) were more frequently associated with rhabdomyolysis than gram-positive pathogens (14.5%).
  • The lung was the most common site of sepsis (38.8%).
  • A high proportion (78.6%) had additional risk factors like statin use, alcoholism, or electrolyte imbalances. Mean creatine kinase was 7114 IU/L.

Conclusions:

  • Gram-negative bacteria are more commonly implicated in sepsis-induced rhabdomyolysis than previously thought.
  • Sepsis-associated rhabdomyolysis is multifactorial, influenced by comorbidities and other risk factors.
  • The condition is associated with a high mortality rate (59%).

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