engleski

The importance of pathogens in sepsis: Staphylococcus aureus story

Different pathogens cause different outcomes for patients with sepsis. They influence on ICU mortality, ICU length of stay (ICU LOS), need for mechanical ventilation (MV). This is a retrospective data-based analysis over 6-year period. 78 patients with methicillin-sensitive Staphylococcus aureus (MSSA) and 74 patients with Escherichia coli (EC) sepsis were included in the study. ICU mortality for MSSA group was 32 (41.0%) vs. 26 (35.1%) for EC (p=0.506 ; OR=1.28, 95%CI 0.67-2.48). There was no significant difference in ICU LOS (MSSA group median 7.5, interquartiles 4-14 days and EC median 5, interquartiles 3-13.5, p=0.214). Need for MV in MSSA group was present in 45 (57.7%) patients vs. 43 (58.1%) in EC group. Univariate analysis did not reveal MSSA was independently associated with ICU mortality (p=0.506). Logistic regression analysis showed that after adjustment for APACHE II, the chance of ICU death doubles in MSSA group (OR=2.166 ; 95%CI 1.004 to 4.858). An increase of APACHE II score per unit increases odds of death (OR=1.158, 95%CI 1.096-1.222). The probability of ending up at ICU was 8 times higher for patients with MSSA-sepsis compared with patients with EC-sepsis. MSSA sepsis should be considered as an independent factor for ICU mortality after adjustment for APACHE II. Patients with MSSA sepsis had more than twice greater chance of ICU death than patients with EC sepsis.

sepsis ; methicillin-sensitive Staphylococcus aureus (MSSA) ; Escherichia coli ; intensive care unit ; outcome

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