Culture positivity may correlate with long-term mortality in critically ill patients

Wei-Fan Ou,Chieh-Liang Wu,Li-Ting Wong,Wen-Cheng Chao

doi:10.1186/s12879-021-06898-8

Abstract

BackgroundThe long-term outcome is currently a crucial issue in critical care, and we aim to address the association between culture positivity and long-term mortality in critically ill patients.MethodsWe used the 2015–2019 critical care database at Taichung Veterans General Hospital and Taiwanese nationwide death registration files. Multivariable Cox proportional hazards regression model was conducted to determine hazard ratio (HR) and 95% confidence interval (CI).ResultsWe enrolled 4488 critically ill patients, and the overall mortality was 55.2%. The follow-up duration among survivors was 2.2 ± 1.3 years. We found that 52.6% (2362/4488) of critically ill patients had at least one positive culture during the admission, and the number of patients with positive culture in the blood, respiratory tract and urinary tract were 593, 1831 and 831, respectively. We identified that a positive culture from blood (aHR 1.233; 95% CI 1.104–1.378), respiratory tract (aHR 1.217; 95% CI 1.109–1.364) and urinary tract (aHR 1.230; 95% CI 1.109–1.364) correlated with an increased risk of long-term mortality after adjusting relevant covariates.ConclusionsThrough linking two databases, we found that positive culture in the blood, respiratory tract and urinary tract during admission correlated with increased long-term overall mortality in critically ill patients.

Highlights

The long-term outcome is currently a crucial issue in critical care, and we aim to address the associa‐ tion between culture positivity and long-term mortality in critically ill patients
Main pathogens in distinct culture sites among critically ill patients We found that 52.6% (2362/4488) of enrolled critically ill patients had at least one positive culture, and the number of subjects with positive culture in the blood, respiratory tract, and urinary tract were 593, 1831, and 831, respectively (Table 2)
We identified that a positive culture from blood, respiratory tract and urinary tract correlated with an increased risk of long-term mortality after adjusting for age, male gender, body mass index (BMI), Charlson comorbidity index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE) II score, and early fluid balance (Table 3)

Summary

Introduction

The long-term outcome is currently a crucial issue in critical care, and we aim to address the associa‐ tion between culture positivity and long-term mortality in critically ill patients. The long-term outcome is currently an emerging research niche in critical care medicine due to increasing awareness of sequelae after the critical illness [1, 2]. Early determinants for long-term outcome in critically ill patients remains largely unexplored. Microbiome-associated studies, have shown the prolonged microbial-associated impact in critically ill patients [3,4,5]. A number of studies have investigated the association between culture positivity and mortality in critically ill patients; discordant evidence were found, and the discrepancy mainly result from the. Ou et al BMC Infectious Diseases (2021) 21:1188

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