Characteristics and outcomes of bacteremia among ICU-admitted patients with severe sepsis

被引：26

作者：

Komori, Akira ^{[1
]}

Abe, Toshikazu ^{[1
,2
,3
]}

Kushimoto, Shigeki ^{[4
]}

Ogura, Hiroshi ^{[5
]}

Shiraishi, Atsushi ^{[6
]}

Saitoh, Daizoh ^{[7
]}

Fujishima, Seitaro ^{[8
]}

Mayumi, Toshihiko ^{[9
]}

Naito, Toshio ^{[1
]}

Hifumi, Toru ^{[10
]}

Shiino, Yasukazu ^{[11
]}

Nakada, Taka-aki ^{[12
]}

Tarui, Takehiko ^{[13
]}

Otomo, Yasuhiro ^{[14
]}

Okamoto, Kohji ^{[15
]}

Umemura, Yutaka ^{[5
]}

Kotani, Joji ^{[16
]}

Sakamoto, Yuichiro ^{[17
]}

Sasaki, Junichi ^{[18
]}

Shiraishi, Shin-ichiro ^{[19
]}

Takuma, Kiyotsugu ^{[20
]}

Tsuruta, Ryosuke ^{[21
]}

Hagiwara, Akiyoshi ^{[22
]}

Yamakawa, Kazuma ^{[23
]}

Masuno, Tomohiko ^{[24
]}

Takeyama, Naoshi ^{[25
]}

Yamashita, Norio ^{[26
]}

Ikeda, Hiroto ^{[27
]}

Ueyama, Masashi ^{[28
,29
]}

Fujimi, Satoshi ^{[23
]}

Gando, Satoshi ^{[30
,31
]}

机构：

[1] Juntendo Univ, Dept Gen Med, Tokyo, Japan

[2] Univ Tsukuba, Hlth Serv Res & Dev Ctr, Tsukuba, Ibaraki, Japan

[3] Univ Tsukuba, Fac Med, Dept Hlth Serv Res, Tsukuba, Ibaraki, Japan

[4] Tohoku Univ, Div Emergency & Crit Care Med, Grad Sch Med, Sendai, Miyagi, Japan

[5] Osaka Univ, Dept Traumatol & Acute Crit Med, Grad Sch Med, Osaka, Japan

[6] Kameda Med Ctr, Emergency & Trauma Ctr, Kamogawa, Japan

[7] Natl Def Med Coll, Res Inst, Div Traumatol, Tokorozawa, Saitama, Japan

[8] Keio Univ, Ctr Gen Med Educ, Sch Med, Tokyo, Japan

[9] Univ Occupat & Environm Hlth, Sch Med, Dept Emergency Med, Kitakyushu, Fukuoka, Japan

[10] St Lukes Int Hosp, Dept Emergency & Crit Care Med, Tokyo, Japan

[11] Kawasaki Med Sch, Dept Acute Med, Kurashiki, Okayama, Japan

[12] Chiba Univ, Dept Emergency & Crit Care Med, Grad Sch Med, Chiba, Japan

[13] Kyorin Univ, Dept Trauma & Crit Care Med, Sch Med, Mitaka, Tokyo, Japan

[14] Tokyo Med & Dent Univ, Med Hosp, Trauma & Acute Crit Care Ctr, Tokyo, Japan

[15] Kitakyushu CityYahata Hosp, Ctr Gastroenterol & Liver Dis, Dept Surg, Kitakyushu, Fukuoka, Japan

[16] Kobe Univ, Dept Disaster & Emergency Med, Grad Sch Med, Kobe, Hyogo, Japan

[17] Saga Univ Hosp, Emergency & Crit Care Med, Saga, Japan

[18] Keio Univ, Dept Emergency & Crit Care Med, Sch Med, Tokyo, Japan

[19] Aizu Chuo Hosp, Dept Emergency & Crit Care Med, Aizu Wakamatsu, Fukushima, Japan

[20] Kawasaki Municipal Kawasaki Hosp, Emergency & Crit Care Ctr, Kawasaki, Kanagawa, Japan

[21] Yamaguchi Univ, Adv Med Emergency & Crit Care Ctr, Ube, Yamaguchi, Japan

[22] Niizashiki Chuo Gen Hosp, Dept Emergency Med, Niiza, Japan

[23] Osaka Gen Med Ctr, Div Trauma & Surg Crit Care, Osaka, Japan

[24] Nippon Med Sch, Dept Emergency & Crit Care Med, Tokyo, Japan

[25] Aichi Med Univ Hosp, Adv Crit Care Ctr, Nagakute, Aichi, Japan

[26] Kurume Univ Hosp, Adv Emergency Med Serv Ctr, Kurume, Fukuoka, Japan

[27] Teikyo Univ, Dept Emergency Med, Sch Med, Tokyo, Japan

[28] Chukyo Hosp, Dept Trauma, Crit Care Med, Japan Community Healthcare Org, Nagoya, Aichi, Japan

[29] Chukyo Hosp, Burn Ctr, Japan Community Healthcare Org, Nagoya, Aichi, Japan

[30] Hokkaido Univ, Div Acute & Crit Care Med, Grad Sch Med, Sapporo, Hokkaido, Japan

[31] Sapporo Higashi Tokushukai Hosp, Dept Acute & Crit Care Med, Sapporo, Hokkaido, Japan

[32] Japan Assoc Acute Med, Tokyo, Japan

来源：

SCIENTIFIC REPORTS | 2020年 / 10卷 / 01期

关键词：

INFLAMMATORY RESPONSE; SEPTIC SHOCK; INFECTION; IMPACT; PROCALCITONIN; DEFINITIONS; GUIDELINES;

D O I：

10.1038/s41598-020-59830-6

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

The clinical implications of bacteremia among septic patients remain unclear, although a vast amount of data have been accumulated on sepsis. We aimed to compare the clinical characteristics and outcomes of severe sepsis patients with and without bacteremia. This secondary analysis of a multicenter, prospective cohort study included 59 intensive care units (ICUs) in Japan between January 2016 and March 2017. The study cohort comprised 1,184 adults (aged >= 16 years) who were admitted to an ICU with severe sepsis and diagnosed according to the Sepsis-2 criteria. Of 1,167 patients included in the analysis, 636 (54.5%) had bacteremia. Those with bacteremia had significantly higher rates of septic shock (66.4% vs. 58.9%, p=0.01) and higher sepsis severity scores, including the Acute Physiology and Chronic Health Evaluation (APACHE) II and the Sequential Organ Failure Assessment (SOFA). No significant difference in in-hospital mortality was seen between patients with and without bacteremia (25.6% vs. 21.0%, p=0.08). In conclusion, half of severe sepsis patients in ICUs have bacteremia. Although patients with bacteremia had more severe state, between-group differences in patient-centered outcomes, such as in-hospital mortality, have not been fully elucidated.

引用

页数：8

共 21 条

[1] Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia [J].