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Prognostic Value of the Time-to-Positivity in Blood Cultures from Septic Shock Patients with Bacteremia Receiving Protocol-Driven Resuscitation Bundle Therapy: A Retrospective Cohort Study

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Abstract
Introduction: To evaluate the prognostic value of the time-to-positivity in patients with culture-positive septic shock. Methods: Retrospective study using a prospective data registry was performed at the emergency department of a tertiary hospital. Consecutive adult patients with septic shock (N = 2499) were enrolled between 2014 and 2018. Bacteremia was defined using blood cultures, and viral and fungal pathogens were excluded. The primary outcome was the 28-day mortality. Results: In 803 (46.7%) septic shock patients with bacteremia, median TTP was 10.1 h. The most prevalent isolated bacterial pathogens were Escherichia coli (40.8%) and Klebsiella (23.4%). Although the TTP correlated with a higher sequential organ failure assessment score (Spearman's rho = -0.12, p < 0.01), it showed no significant difference between the 28-day survivors and non-survivors (10.2 vs. 9.4 days, p = 0.35). In subgroup analysis of the Escherichia coli and Klebsiella bacteremia cases, a shorter TTP showed prognostic value for predicting the 28-day mortality. The optimal TTP cut-off for Escherichia coli and Klebsiella was 10 h and 8 h, respectively. Conclusions: The prognostic value of the TTP in septic shock patients receiving bundle therapy may be limited and its clinical interpretation should only be made on a pathogen-specific basis.
Author(s)
김무열김원영김윤정김준성배홍준
Issued Date
2021
Type
Article
Keyword
bacteremiamortalitysepsisseptic shocktime-to-positivity
DOI
10.3390/antibiotics10060683
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8301
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_ecb5dfc6a5b14a94994c0f6af3261440&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Prognostic%20Value%20of%20the%20Time-to-Positivity%20in%20Blood%20Cultures%20from%20Septic%20Shock%20Patients%20with%20Bacteremia%20Receiving%20Protocol-Driven%20Resuscitation%20Bundle%20Therapy:%20A%20Retrospective%20Cohort%20Study&amp;offset=0&amp;pcAvailability=true
Publisher
ANTIBIOTICS-BASEL
Location
미국
Language
영어
ISSN
2079-6382
Citation Volume
10
Citation Number
683
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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