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Polymicrobial sepsis: an analysis of 184 cases using log linear models
Abstract:
Polymicrobial sepsis is a common and frequently fatal clinical condition that has received relatively little attention in published reports. Retrospectively, we reviewed the case records of 184 patients with polymicrobial sepsis seen at three Dallas hospitals between 1972 and 1977. Analysis of clinical data using log linear models enabled us to identify significant positive correlations (p < 0.05) between mortality resulting from polymicrobial sepsis and underlying disease category, failure to manifest fever, a pulmonary portal of entry, hypotension, and hospital-associated sepsis. No significant correlation with outcome could be demonstrated for age, hospital service, species of infecting microorganisms, number of microorganisms isolated from blood, WBC count, or antimicrobial therapy. In spite of indirect evidence for synergistic relationships between microorganisms responsible for polymicrobial sepsis in man, we could not resolve whether antimicrobial regimens that are effective against all of the microorganisms participating in polymicrobial infections are required to insure a favorable outcome.
Insights
Polymicrobial sepsis, a serious condition, is linked to underlying diseases, lack of fever, lung infections, low blood pressure, and hospital-acquired infections. Treatment effectiveness remains unclear.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Epidemiology
Background:
- Polymicrobial sepsis is a prevalent and often fatal condition.
- Limited research has focused on this specific clinical entity.
Purpose of the Study:
- To retrospectively analyze clinical data of polymicrobial sepsis patients.
- To identify factors correlated with mortality in polymicrobial sepsis.
Main Methods:
- Review of 184 patient case records from 1972-1977.
- Utilized log-linear models for statistical analysis of clinical data.
Main Results:
- Mortality correlated positively with underlying disease, absence of fever, pulmonary source, hypotension, and hospital-associated sepsis.
- No significant correlation found with age, hospital service, microbial species, microbial load, WBC count, or antimicrobial therapy.
Conclusions:
- Identified key clinical factors associated with increased polymicrobial sepsis mortality.
- The necessity of broad-spectrum antimicrobial therapy against all causative agents requires further investigation.