Positive Culture and Prognosis in Patients With Sepsis: A Prospective Cohort Study

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Clinical Microbiology

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• The prognostic significance of positive microbiological cultures in sepsis remains a subject of investigation.
• Accurate prognostic markers are crucial for guiding sepsis management and improving patient outcomes.

Purpose of the Study:

• To investigate the prognostic role of positive microbiological cultures in adult patients diagnosed with sepsis.
• To determine if positive cultures are associated with hospital mortality, length of hospital stay, or the development of secondary infections.

Main Methods:

• A prospective cohort study was conducted in a tertiary referral hospital.
• Adult patients meeting Centers for Disease Control criteria for bacterial infection and sepsis were included.
• Logistic and Cox regression models, including competing risk analysis, were employed to assess associations.

Main Results:

• 408 patients had positive cultures, while 153 had negative cultures.
• Initially, positive cultures appeared linked to lower mortality, but this was not significant after adjusting for confounders (OR, 0.56; 95% CI, 0.31-1.01).
• No significant association was found between positive cultures and hospital stay (aSHR, 1.06; 95% CI, 0.83-1.35) or secondary infections (aSHR, 0.99; 95% CI, 0.58-1.71).

Conclusions:

• Positive microbiological cultures are not independently associated with prognosis in patients with sepsis.
• The findings suggest that routine microbiological culture results may not serve as a direct prognostic indicator for sepsis outcomes.
• Further research may be needed to identify reliable prognostic markers in sepsis management.