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Culture-Negative Septic Shock Compared With Culture-Positive Septic Shock: A Retrospective Cohort Study.
Shravan Kethireddy1,2, Beliz Bilgili3, Amanda Sees4
1The Departments of Critical Care Medicine, Geisinger Medical Center, Danville, PA.
Critical Care Medicine
|January 3, 2018
Summary
Culture-negative septic shock patients show similar outcomes to culture-positive septic shock patients, with both groups benefiting from early antimicrobial therapy. Prompt treatment is key for improving survival in septic shock.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Septic shock is a life-threatening condition with significant mortality.
- Distinguishing between culture-negative and culture-positive septic shock is crucial for understanding disease characteristics and outcomes.
- Previous research has yielded varied results regarding the differences in clinical presentation and prognosis.
Purpose of the Study:
- To compare the clinical characteristics and outcomes of patients with culture-negative septic shock versus culture-positive septic shock.
- To identify factors influencing mortality in both septic shock groups.
- To evaluate the impact of antimicrobial therapy timing on patient survival.
Main Methods:
- A retrospective nested cohort study was conducted using a trinational database.
- Data were collected from 8,670 patients with septic shock across 28 academic and community hospitals between 1997 and 2010.
- Patients were categorized into culture-negative (n=2,651) and culture-positive (n=6,019) septic shock groups.
Main Results:
- Culture-negative septic shock patients exhibited similar ICU survival (58.3%) and hospital survival (47.3%) compared to culture-positive septic shock patients (59.5% and 47.1%, respectively).
- Severity of illness (APACHE II score) and serum lactate levels were comparable between the two groups.
- Increased delays in appropriate antimicrobial therapy were associated with higher hospital mortality in both culture-negative and culture-positive septic shock groups.
Conclusions:
- Clinical characteristics and outcomes for culture-negative septic shock are largely similar to those with culture-positive septic shock.
- Early administration of appropriate antimicrobial therapy is a critical factor in improving hospital survival for all septic shock patients.
- Prompt recognition and effective management of infection are paramount for enhancing patient outcomes.
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