Work

Community-acquired sepsis in the medical intensive care unit – an experience from a lower-middle-income country

Year: 2024

Type: article

Abstract: Objectives: To determine microbiological pathogens and in-hospital mortality in patients admitted with communityacquired sepsis to the intensive care unit in a tertiary-care setting in a low- and middle-income country. METHODS: The retrospective, observational study was conducted at the medical intensive care unit of a large tertiary care hospital in Karachi, and comprised data from January 1 to December 31, 2019 of patients with community-acquired sepsis who were assessed using the Sepsis-3 criteria. Data was compared between survivors and non-survivors, and independent factors associated with in-hospital mortality were identified. Data was analysed using SPSS 23. RESULTS: Of the 135 patients with mean age 49.8±18.0 years, 91(67.4%) were males and 44(32.6%) were females. The most common primary site of infection was the respiratory tract 63(46.7%). Multi-drug-resistant organisms were isolated in 39 (28.9%) patients. In-hospital mortality was noted in 52(38.5%) cases, while there were 83(61.5%) survivors. Serum levels of lactate and bicarbonate as well as urine output, fungal pathogens, septic shock and sequential organ failure assessment score were significantly associated with mortality (p<0.05). CONCLUSIONS: Clinical and microbiological spectrum of community-acquired sepsis in a low- and middle-income country was found to be different from other regions of the world. Clinicians should keep these differences in mind while managing these critically ill patients.

Source: Journal of the Pakistan Medical Association

DOI: 10.47391/jpma.11323

Authors: Huzefa Jibril, Syed Ahsan Ali, Safia Awan, Iffat Khanum

Institution: Aga Khan University

Language: English

Topic: Sepsis Diagnosis and Treatment

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $650