Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study
Authors' conclusion
In patients with septic shock, culture-negativity was associated with increased mortality, despite the paradoxically higher appropriateness of empirical antibiotics than culture-positive patients.
Study context
- Population
- Sepsis-3 patients referred to the ICU through the ED, Korean Sepsis Alliance registry (21 intensive care units (ICUs), 20 hospitals), September 2019 to December 2021analysed of 11,981
- Participants
- 3,501 patients
- Exposure
- Culture-negative vs culture-positive sepsis
- Culture-positive sepsisn = 2,213reference
- Culture-negative sepsisn = 1,288
- Outcome
- In-hospital mortality
Methodological detailsnationwide, multicentre registry
- Nationwide
- Multicentre registry
Main finding
As reported in the abstract
P = 0.073
Observational data: associations, not effects.
Further findings
In-hospital mortality, septic shock (subgroup)
P = 0.029
Compliance with fluid resuscitation
P = 0.038
Earlier vasopressor administration
P = 0.012
Culture-negativity as independent predictor of poor prognosis, septic shock (subgroup)
- Culture-negativity independently predicted poor prognosis in septic shock: OR 1.462, 95% CI 1.060-2.017, p = 0.021
Apparent appropriateness of empirical antibiotics, septic shock (subgroup)
- Higher in culture-negative vs culture-positive septic shock: 96.8% vs 85.2%, p < 0.001
Original publication
Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study. Crit Care. Published 25 November 2024. doi:10.
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