Epidemiology of Sepsis in Chinese Intensive Care Units: A National Cross-Sectional Survey

Xie, Jianfeng; Wang, Hongliang; Kang, Yan; Zhou, Lixin; Qin, Bingyu; Liu, Zhongmin; Ma, Xiaochun; Chen, Dechang; Cao, Xiangyuan; Lü, Weihua; Yao, Chen; Yu, Kaijiang; Yao, Xiaoqing; Shang, Hongcai; Qiu, Haibo; Yang, Yong

doi:10.2139/ssrn.3220105

Cited by 45 publications

(59 citation statements)

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“…However, we also found that the composition ratio of hospital acquired BSIs increased significantly annually (from 73.4-76.2%). This result was consistent with the increase in various hospital-acquired infections in recent years [16,17] , and the risk factors may be related to the risk factors for BSIs and (or) hospital-acquired infections reported in many previous studies, such as ICU admission, the older age of hospitalized patients (aging population), prolonged hospital stay, leukocytopenia, acute myeloid leukemia and (or) increased use of invasive procedures including central venous catheters (CVCs) [18][19][20] . However, more details of the risk factors require further statistical analysis of the decrease in hospital-acquired BSIs in our hospital.…”

Section: Discussionsupporting

confidence: 90%

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

Cui¹,

Li²,

Wang³

et al. 2020

Preprint

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Background Recent epidemiological studies on bloodstream infections (BSIs) that include the incidence rate, species distribution and dynamic changes are scarce in China. This study was performed to understand these epidemiological data of BSIs over the past 10 years in China. Method Using real-time nosocomial infection surveillance system, this study was retrospectively performed on BSIs in one of the largest hospitals in China, from January 2010 to December 2019. Results From 2010 to 2019, there were totally 9381 episodes of BSIs out of 1,437,927 adult hospitalized patients in the hospital, the total incidence rate of BSIs was 6.50‰ (6.50 episodes per 1000 adult-hospitalized patients per year) and the incidence rates had significantly decreased (8.24‰ to 6.00‰, time trend P <0.05). Among the 9381 episodes of BSIs, 93.1% were bacteremia and others (6.9%) were fungemia. As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6% to 32.5%), Escherichia coli (9.8% to 13.6%) and Klebsiella pneumonia (5.3% to 10.4%) had been dynamic increased (time trends P <0.05) and the proportion of Pseudomonas aeruginosa had dynamic decreased (4.0% to 2.4%, time trend P =0.007). However, Staphylococcus aureus (3.3% to 3.1%) and Acinetobacter baumannii (4.4% to 4.2%) had not changed significantly (time trend P >0.05). These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. Additionally, among bacteremia, the proportion of the multidrug-resistant bacteria gradually increased from 52.9% to 68.4% (time trend P <0.001). Conclusion The incidence rate and the species distribution had been dynamic changing and this study could be supplements to the 2018 CHINET report.

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Section: Discussionsupporting

confidence: 90%

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

Cui¹,

Li²,

Wang³

et al. 2020

Preprint

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“…3 Accumulated evidence has strongly demonstrated that systemic inflammatory response, acute kidney injury (AKI) and fluid overload (FO) were associated with high mortality in severe sepsis. [4][5][6] In critically ill patients with COVID-19, the overwhelming inflammation including C-reactive protein (CRP) and interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor α (TNF-α) were observed, 7-10 which is consistent with patients suffering from SARS-CoV 11 and MERS-CoV. 12 Continuous renal replacement therapy (CRRT) is a great help in critically ill patients not only to control of electrolyte, acid-base derangements but also to remove inflammatory mediators and improves oxygenation in fluid overload.…”

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confidence: 99%

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Yang

Shi

et al. 2020

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“…This was a sub-analysis of Chinese Epidemiological Study of Sepsis (CHESS) study [9] , which was a multicenter prospective cross-sectional survey performed in mainland China involving 44 hospitals, commenced on December 1, 2015 and concluded on January 31, 2016. Patients with suspected or con rmed sepsis admitted to intensive care unit (ICU) and with blood and/or any other samples from suspected infected sites sent at admittance was included in the present study.…”

Section: Design and Settingsmentioning

confidence: 99%

Septic Patients Benefited from Positive Microbial Culture in Mortality: A Propensity Score Matching (PSM) of the Chinese Epidemiological Study of Sepsis (CHESS) Study

Chang

Xie

Sun

et al. 2020

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Background We aimed to investigate the characteristics and outcomes in septic patients with positive cultures compared with negative cultures. Methods This was a sub-analysis of a cross-section survey study including 44 hospitals in mainland China from December 1, 2015 to January, 31,2016. All septic patients diagnosed according to sepsis-1 criteria admitted to participating ICU, with cultures from any suspected sites of infection obtained at admission. Demographic information, patient source, clinical feature, laboratory findings and severity of sepsis were comprehensively collected for comparison the characteristics between culture positive and negative patients. Univariable and multivariable regression were used to find the factors associated with positive culture and propensity score matching (PSM) was performed to compare the mortality. Results A total of 1919 patients were enrolled in this study with 962 (50.1%) positive-culture and 975 (49.9%) negative-culture. Positive culture was associated with older age, male gender, transferred patients, comorbidities including coronary heart decease and solid tumor, prolonged priori ICU stay, hospital-acquired infection, pneumonia and bloodstream infection, also with higher body temperature, heart rate, procalcitonin levels and with higher APACHE II and SOFA score at admission. Negative culture was associated with prior antibiotic exposure and community-acquired infections. Patients with positive culture had an insignificantly higher mortality (37.5% vs. 34.5, P = 0.165). However, PSM revealed decreased mortality in patients with positive culture (38.2% vs. 48.2%, P = 0.012), and a significantly higher proportion of patients received targeted antibiotic treatment in survivors (37.0% vs. 46.2%, P = 0.031). Conclusions A myriad of factors may affect the results of culture. Septic patients were likely to benefit from positive cultures in mortality possibly due to the higher proportion to receive targeted antibiotic treatment, and obtaining positive culture as possible should be strongly encouraged.

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Epidemiology of Sepsis in Chinese Intensive Care Units: A National Cross-Sectional Survey

Cited by 45 publications

References 0 publications

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Septic Patients Benefited from Positive Microbial Culture in Mortality: A Propensity Score Matching (PSM) of the Chinese Epidemiological Study of Sepsis (CHESS) Study

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