Characteristics and outcomes of bacteremia among ICU-admitted patients with severe sepsis
Akira Komori, Toshikazu Abe, Shigeki Kushimoto, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toshio Naito, Toru Hifumi, Yasukazu Shiino, Taka‐aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin‐ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando, JAAM FORECAST group, Osamu Tasaki, Yasumitsu Mizobata, Hiraku Funakoshi, Toshiro Okuyama, Iwao Yamashita, Toshio Kanai, Yasuo Yamada, Mayuki Aibiki, Keiji Sato, Susumu Yamashita, Ken Yoshida, Shunji Kasaoka, Akihide Kon, Hiroshi Rinka, Hiroshi Kato, Hiroshi Okudera, Eichi Narimatsu, Toshifumi Fujiwara, Manabu Sugita, Yasuo Shichinohe, Hajime Nakae, Ryouji Iiduka, Mitsunobu Nakamura, Yuji Murata, Yoshitake Sato, Hiroyasu Ishikura, Yasuhiro Myojo, Yasuyuki Tsujita, Kosaku Kinoshita, Hiroyuki Yamaguchi, Toshihiro Sakurai, Satoru Miyatake, Takao Saotome, Susumu Yasuda, Yasuaki Mizushima
Abstract
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.