Comparative Analysis of Bacteremic and Non-bacteremic Sepsis: A Retrospective Study

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• Sepsis is a frequent critical illness in emergency departments and ICUs.
• Culture-negative sepsis accounts for 30-60% of cases, with unclear impacts on treatment and outcomes.
• Conflicting evidence exists regarding differences between Gram-positive and Gram-negative infections.

Purpose of the Study:

• To compare characteristics and outcomes of culture-positive versus culture-negative sepsis.
• To analyze the influence of bacterial Gram staining on sepsis outcomes.

Main Methods:

• Retrospective cohort study of 1375 ICU patients (2016-2019).
• Included patients with sepsis or septic shock and excluded those without cultures or with non-bacterial infections.
• Primary outcome: disease severity. Secondary outcomes: mortality, hospital and ICU length of stay.

Main Results:

• 68.5% of patients were culture-negative (943/1375).
• Culture-positive patients had higher likelihood of vasopressor use (aOR 1.98) and steroid administration (aOR 1.68).
• No significant differences in mortality or length of stay between culture-positive and culture-negative groups.

Conclusions:

• Significant differences in illness severity exist between culture-negative and culture-positive sepsis.
• Patient-oriented outcomes like mortality and length of stay were similar between groups.
• Clinicians should not be reassured by the absence of bacteremia in suspected sepsis cases.