Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States*
Authors' conclusion
In patients hospitalized with community-onset sepsis, the prevalence of blood culture-positive sepsis was 14%. Among positive blood culture sepsis resistant organisms were infrequent. Compared with culture-negative sepsis, blood culture-positive sepsis and nonblood culture-positive sepsis were associated with lower in-hospital mortality.
Study context
- Population
- Adults with community-onset sepsis (CDC Adult Sepsis Event criteria) with blood cultures within 2 days of admission, 201 US hospitals, 2016–2020 (Premier Healthcare Database)
- Participants
- 147,061 adults · 201 US hospitals
- Exposure
- Blood culture-positive and nonblood culture-positive sepsis vs culture-negative sepsis
- Blood culture-positive sepsisn = 21,167
- Nonblood culture-positive sepsisn = 20,326
- Outcome
- Prevalence of culture categories and in-hospital mortality
Methodological detailsmulticentre, multilevel logistic regression
- Multicentre
- Multilevel logistic regression
Main finding
As reported in the abstract
Each group vs culture-negative sepsisAdjusted odds ratio (95% CI)
Blood culture-positive sepsis
0.89(0.85–0.94)
Nonblood culture-positive sepsis
0.82(0.78–0.87)
Observational data: associations, not effects.
Further findings
Pathogens and resistance in blood culture-positive sepsis
- Gram-negative rods
- 55%
- Gram-positive cocci
- 47%
- Methicillin-resistant Staphylococcus aureus (MRSA)
- 11%
- Ceftriaxone-resistant Enterobacterales/ESBL
- 7%
- Carbapenem-resistant Enterobacterales
- 1.3%
In-hospital mortality by pathogen
- Acinetobacter spp, Pseudomonas aeruginosa, MSSA and MRSA associated with higher in-hospital mortality
- Escherichia coli, Klebsiella, Proteus and Streptococcus spp associated with lower in-hospital mortality
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States*. Crit Care Med. Published 5 April 2023. doi:10.
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