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Updated: Oct 2, 2025
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Correlation of clinical sepsis definitions with microbiological characteristics in patients admitted through a sepsis
David Yu1,2, David Unger, Christian Unge2,3
1Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Background:
Sepsis was recently redefined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. With this redefinition (Sepsis-3), clinical and microbiological characteristics of patients with sepsis may differ from the patients fulfilling the previous definition (Sepsis-2).
Purpose:
To describe differences in clinical and microbiological characteristics of sepsis episodes between Sepsis-3 and Sepsis-2. The secondary aim was to compare blood culture outcomes between episodes fulfilling Sepsis-3 and Sepsis-2 criteria, respectively.
Methods:
A prospective study design was used to include patients presenting with clinically suspected sepsis in the emergency department. Six blood culture bottles were collected from each patient. Blood cultures were described as having clinically relevant growth, contaminant growth, or no growth. Clinical and laboratory data were collected from medical records and the laboratory information system.
Results:
The analysis included 514 episodes. There were 357/514 (79.5%) Sepsis-3 and 411/514 (80.0%) Sepsis-2 episodes. In total, 341/514 (66.3%) episodes fulfilled both Sepsis-3 and Sepsis-2 criteria. Blood cultures were positive for clinically relevant growth in 130/357 (36.1%) and 145/411 (35.3%) episodes in Sepsis-3 and Sepsis-2, respectively. Other clinical and microbiological characteristics did not differ between Sepsis-3 and Sepsis-2.
Conclusions:
A high proportion of patients included through a sepsis alert system fulfilled both Sepsis-3 and Sepsis-2 criteria. The performance of blood cultures in detection of microorganisms was poor and were similar in Sepsis-3 and Sepsis-2 patients.
Insights
The Sepsis-3 and Sepsis-2 definitions captured similar patient characteristics and yielded comparable blood culture results. Blood culture performance for detecting microorganisms in sepsis cases was poor under both definitions.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Microbiology
Background:
- Sepsis definition updated to Sepsis-3, emphasizing life-threatening organ dysfunction from dysregulated host response to infection.
- Potential differences in patient characteristics between Sepsis-3 and prior Sepsis-2 definitions warrant investigation.
Purpose of the Study:
- Compare clinical and microbiological characteristics of sepsis episodes between Sepsis-3 and Sepsis-2 criteria.
- Evaluate differences in blood culture outcomes between Sepsis-3 and Sepsis-2 episodes.
Main Methods:
- Prospective study of patients with suspected sepsis in the emergency department.
- Collected six blood culture bottles per patient, noting clinically relevant growth, contaminant growth, or no growth.
- Gathered clinical and laboratory data from medical records and laboratory information systems.
Main Results:
- Analysis included 514 sepsis episodes; 79.5% met Sepsis-3 and 80.0% met Sepsis-2 criteria.
- 66.3% of episodes fulfilled both Sepsis-3 and Sepsis-2 criteria.
- Clinically relevant blood culture growth occurred in 36.1% (Sepsis-3) and 35.3% (Sepsis-2) of episodes; other characteristics did not differ.
Conclusions:
- A significant proportion of sepsis alert system patients met both Sepsis-3 and Sepsis-2 criteria.
- Blood culture performance for microorganism detection was poor and similar for both sepsis definitions.
- Clinical and microbiological characteristics showed no significant differences between Sepsis-3 and Sepsis-2.
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