scholarly journals EPIDEMIOLOGY AND OUTCOME AMONG SEVERE SEPSIS AND SEPTIC SHOCK PATIENTS IN A SOUTH INDIAN TERTIARY CARE HOSPITAL

2017 ◽  
Vol 9 (5) ◽  
pp. 256
Author(s):  
Merin Babu ◽  
Vidya P Menon ◽  
Uma Devi P.
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Tertiary Care ◽  
Positive Culture ◽  
Relevant Information ◽  
Care Hospital ◽  
Gram Negative ◽  
Main Site ◽  
South Indian ◽  
Sepsis And Septic Shock

Objective: The objective of this research was to determine the prevalence of severe sepsis and septic shock and evaluate its outcome.Methods: This was a prospective, observational study, in which adult patients with severe sepsis or septic shock were included. Relevant information was collected from medical records and the hospital information system.Results: A total of 250 patients [mean age 57.2 y (range: 18 to 98 y)] was studied. The majority of the patients suffered from severe sepsis (81.2%). Most of the episodes occurred in males (75.2%). Major comorbidities included diabetes mellitus (51.2%), hypertension (44.8%) and chronic liver disease (30.4%). One hundred and seventy-eight patients (147 patients with severe sepsis and 31 patients with septic shock) had a positive culture with urine being the main site of infection. One hundred and two patients (40.8%) had a monomicrobial infection while seventy-six (30.4%) patients had a polymicrobial infection. Within the monomicrobial infections, the gram negative organisms predominated (54%). The mean hospital stay for patients with severe sepsis was 11.5 d. Mortality was noted in 79 patients (40 patients with septic shock and 39 patients with severe sepsis).Conclusion: The main causative pathogens were gram negative bacteria. Admissions meeting septic shock criteria have a high mortality rate. Hence, it is imperative to identify patients who are at high risk and treat them promptly to reduce serious consequences.

scholarly journals Prognostic value of Amino Terminal Pro B-type Natriuretic Peptide (NT-proBNP) in patient with severe sepsis and septic shock in an ICU of tertiary care hospital of Bangladesh.

2018 ◽  
Vol 6 (2) ◽  
pp. 65-70
Author(s):  
Tarikul Hamid ◽  
Rozina Sultana ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Tertiary Care ◽  
Whole Body ◽  
Care Hospital ◽  
Inflammatory Reactions ◽  
Icu Admission ◽  
Amino Terminal ◽  
Sepsis And Septic Shock

Background: Severe sepsis and septic shock are the leading cause of ICU admission. Despite the adequate resuscitation, septic shock is frequently associated with multiple system organ failure (MSOF) and death. This study examined the clinical utility of the level of NT-proBNP as an indicator of outcome in severe sepsis and septic shock.Objectives: to find relationship between level of NT-Pro-BNP and the outcome of the patients of severe sepsis and septic shock.Design: This Prospective observational study done in ICU of BIRDEM General Hospital.Method: All consecutive patients who were diagnosed as severe sepsis and septic shock according to SSC (Surviving Sepsis Campaign) guidelines fulfilling the selection criteria were included in the study. Informed written consent was taken from patient’s first degree relatives. Just after admission of severe sepsis and septic shock patients into ICU and development of severe sepsis or septic shock of previously admitted ICU patients, blood sample for serum NT-proBNP level was sent to hospital laboratory. 28 days were taken as follow up period for all patients in this study. Outcome was measured by mortality. Those who were discharged or transferred were classified as survivors and those who were died, categorized as non survivors. Those who were neither discharged nor dead during the study period were classified as survivors. Patient’s resusci-tation and management were done according to the standard ICU protocol of BIRDEM General Hospital.Result: A total 127 of patients fulfilled the criteria of sepsis and septic shock and study inclusion criteria during the study period. The mean & SD of age in this study was 63.69 ± 17.79 years. 52% (n = 66) were male & 48% (n = 61) were female. Here DM was the most common (83.5%) comorbidity and predominant diagnoses were Pneumonia (58.3%) & UTI (30.7%). Among 127 patients, 24.4% (n=31) were in septic shock and 75.6% (n= 96) patients present with severe sepsis. Level of NT-proBNP of severe sepsis patients were 4608.64 ± 7712.12 & Level of NT-proBNP of septic shock patients were 19239.06 ± 13058.05 (P<0.0001). Among 31 (24.4%) septic shock patients, 32.2% (n=10) patients were survivor and NT-proBNP level was 7333.50 ± 10624 pg/ml; 67.8% (n=21) patients were non survivor and NT-proBNP level was 24908.38 ± 10017.87 pg/ml (P <0.001). In this study among 96 (75.6%) patients with severe sepsis, 88.7% (n=86) were survivor and NT-proBNP level was 2436.41 ± 3755.03 pg/ml; 11.3% (n=11) patients were non-survivors and NT-proBNP level was 21238.36 ± 10095.34 pg/ml (P<0.0001).Conclusion: Severe sepsis and septic shock are the leading cause of ICU admission and also leading cause of death. Our study showed that, elderly with diabetes mellitus had developed more sepsis. Pneumonia and UTI are commonest cause of sepsis.Sepsis causes extreme inflammatory reactions involving all organs of whole body including heart, causing release of NT-proBNP. Raised level of this biomarker associated with increased rate of mortality.Bangladesh Crit Care J September 2018; 6(2): 65-70

Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia

2011 ◽  
Vol 62 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Cheol-In Kang ◽  
Jae-Hoon Song ◽  
Doo Ryeon Chung ◽  
Kyong Ran Peck ◽  
Kwan Soo Ko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Gram Negative ◽  
Gram Negative Bacteremia ◽  
Sepsis And Septic Shock

The epidemiology of, and risk factors for, mortality from severe sepsis and septic shock in a tertiary-care university hospital setting

2009 ◽  
Vol 137 (9) ◽  
pp. 1333-1341 ◽  
Author(s):  
B. KHWANNIMIT ◽  
R. BHURAYANONTACHAI
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Hospital Mortality ◽  
Tertiary Care ◽  
Hospital Setting ◽  
University Hospital ◽  
Apache Ii Score ◽  
Sepsis And Septic Shock ◽  
Hospital Acquired

SUMMARYThis study investigated the clinical characteristics of, and outcomes and risk factors for hospital mortality of 390 patients admitted with severe sepsis or septic shock in an intensive care unit (ICU). Prospectively collected data from patients collected between 1 July 2004 and 30 June 2006 were analysed. Overall hospital mortality was 49·7% and comorbidities were found in 40·3% of patients, the most common of which was haematological malignancy. The respiratory tract was the most common site of infection (50%). Hospital-acquired infections accounted for 55·6% of patients with Gram-negative bacteria predominant (68%). Multivariate analysis showed that acute respiratory distress syndrome, pulmonary artery catheter placement, comorbidities, hospital-acquired infection, APACHE II score and maximum LOD score, were independent risk factors for hospital mortality. In conclusion, severe sepsis and septic shock are common causes of ICU admission. Patients with risk factors for increased mortality should be carefully monitored and aggressive treatment administered.

scholarly journals ARBEKACIN – A RAY OF HOPE TO FIGHT AGAINST MDR AND XDR GRAM-NEGATIVE BACTERIA IN A SCIENTIFIC AND COST-EFFECTIVE WAY IN INDIAN SCENARIO

2020 ◽  
pp. 121-125
Author(s):  
SOMA SARKAR ◽  
DIPANKAR SARKAR ◽  
ANJUM NAMHATA ◽  
MANIDEEPA SENGUPTA
Keyword(s):  
Severe Sepsis ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Good Alternative ◽  
Clinical Samples ◽  
Care Hospital ◽  
Drug Resistant ◽  
Sensitivity Testing ◽  
Gram Negative

Objective: The objective of the study was to see the in vitro activity of arbekacin, a novel aminoglycoside, against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacilli (GNB) so that it can become a good alternative as empirical treatment for severe sepsis. Methods: Identification and antibiotic sensitivity testing of the GNB isolated from the clinical samples were done using the VITEK-II system in a tertiary care hospital, Kolkata. MDR and XDR strains were selected by their definitions and molecular characterization was done by multiplex polymerase chain reaction. The minimum inhibitory concentration (MIC) value of arbekacin was detected by the E-test strip and compared with other aminoglycosides. Results: A total of 140 drug-resistant strains including ESBL- and carbapenemase-producing GNB were selected for the study. Arbekacin showed reduced values of MIC50 and MIC90 compared to other aminoglycosides for most of the drug-resistant GNB. Conclusion: Hence, in this drug-resistant era, arbekacin with the advantage of a single daily dose can be used as an empirical choice in severe sepsis as monotherapy or in combination with other antibiotics such as colistin or polymyxin to fight against MDR and XDR bugs.

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