Epidemiology of Community-Acquired Sepsis: Data from an E-Sepsis Registry of a Tertiary Care Center in South India
Fabia Edathadathil,
Soumya Alex,
Preetha Prasanna,
Sangita Sudhir,
Sabarish Balachandran,
Merlin Moni,
Vidya Menon,
Dipu T. Sathyapalan,
Sanjeev Singh
Affiliations
Fabia Edathadathil
Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Soumya Alex
Department of Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Preetha Prasanna
Department of Medical Administration, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Sangita Sudhir
Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Sabarish Balachandran
Clinical Assistant Professor, Department of Emergency Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Merlin Moni
Clinical Associate Professor, Department of General Medicine and Division of Infectious Diseases, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Vidya Menon
NYC Health + Hospitals/Lincoln, 234 East 149th Street, Suite 8-20, Bronx, NY 10451, USA
Dipu T. Sathyapalan
Clinical Associate Professor, Department of General Medicine and Division of Infectious Diseases, Amrita Institute of Medical Sciences and Research Centre, Kochi 682041, Kerala, India
Sanjeev Singh
Medical Director, Amrita Hospitals and Research Center, Faridabad 121002, Haryana, India
The study aims to characterize community-acquired sepsis patients admitted to our 1300-bedded tertiary care hospital in South India from the Surviving Sepsis Campaign (SSC) guideline-compliant e-sepsis registry stratified by focus of infection. The prospective observational study recruited 1009 adult sepsis patients presenting to the emergency department at the center based on Sepsis-2 criteria for a period of three years. Of the patients, 41% were between 61 and 80 years with a mean age of 57.37 ± 13.5%. A total of 13.5% (136) was under septic shock and in-hospital mortality for the study cohort was 25%. The 3 h and 6 h bundle compliance rates observed were 37% and 49%, respectively, without significant survival benefits. Predictors of mortality among patients with bloodstream infections were septic shock (p = 0.01, OR 2.4, 95% CI 1.23–4.79) and neutrophil-to-lymphocyte ratio (p = 0.008, OR 1.01, 95% CI 1.009–1.066). The presence of Acinetobacter (p = 0.005, OR 4.07, 95% CI 1.37–12.09), Candida non-albicans (p = 0.001, OR16.02, 95% CI 3.0–84.2) and septic shock (p = 0.071, OR 2.5, 95% CI 0.97–6.6) were significant predictors of mortality in patients with community-acquired pneumonia. The registry has proven to be a key data source detailing regional microbial etiology and clinical outcomes of adult sepsis patients, enabling comprehensive evaluation of regional community-acquired sepsis to tailor institutional sepsis treatment protocols.
