engleski

Community-aquired sepsis - etiopathogenesis and mortality

The goal of this retrospective study was to determine the etiopathogenesis and mortality of community-aquired sepsis. The study included 520 patients older than 9 years of age, admitted to our hospital from January 1, 1994 to June 30, 1999. The disease was etiologicaly proven in 65.7% (342/520) patients. Gram-negative bacteria were isolated in 181 (34.8%) patient, while Gram-positive bacteria were the offendin agent in 148 (28.4%) patients. Polymicrobial sepsis was diagnosed in 13 (2.5%) patients. E. coli was the most frequently isolated Gram-negative pathogen (114 patients), followed by K. pneumoniae (15 patients), P. mirabilis (11 patients) and N. meningitidis (10 patients). The most frequent Gram-positive pathogen was S. aureus (56 patients), followed by S. pneumoniae (32 patients) and BHS-A (12 patients). Primary sepsis was diagnosed in 32.6% patients, and secondary sepsis in the rest of the patients. The overall mortality was 20.0%. Mortality rate in patients with gram-positive sepsis was 22.9% vs. 13.2% in patients with Gram-negative sepsis. At the University Hospital for Infectious Diseases, the majority of bacteremic episodes were associated with Gram-negative microorganisms from urinary tract. There was no significant difference between the mortality of Gram-negative and Gram-positive sepsis. The most frequently isolated pathogen was E. coli. Patients with urosepsis were at significantly lower risk of dying than those with the source of infection in respiratory tract. Patients with underlying diseases had significantly greater risk of dying. The analysis suggests that the following factors are associated to statistically significant increase in the mortality rates due to sepsis: age above 80, presence of shock at time of admission, septic meningitis, underlying diseases and finally the source of infection in respiratory tract and unknown sources.

sepsis; community-aquired; etiophatogenesis; mortality

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