Community-acquired sepsis in the medical intensive care unit – an experience from a lower-middle-income country

Authors

  • Huzefa Jibril Department of Medicine, The Aga Khan University, Karachi, Pakistan
  • Syed Ahsan Ali Department of Medicine, The Aga Khan University, Karachi, Pakistan
  • Safia Awan Department of Medicine, The Aga Khan University, Karachi, Pakistan
  • Iffat Khanum Department of Medicine, The Aga Khan University, Karachi, Pakistan

DOI:

https://doi.org/10.47391/JPMA.11323

Keywords:

sepsis, septic shock, critical care, drug resistance, fungi

Abstract

Objective: To determine microbiological pathogens and in-hospital mortality in patients admitted with community-acquired sepsis to the intensive care unit in a tertiary-care setting in a low- and middle-income country.

Methods: The retrospective, observational study was conducted at the medical intensive care unit of a large tertiary care hospital in Karachi, and comprised data from January 1 to December 31, 2019, and comprised data of patients with community-acquired sepsis who were assessed using the Sepsis-3 criteria. Data was compared between survivors and non-survivors, and independent factors associated with escalation to a higher level of care were identified. Data was analysed using SPSS 23.

Results: Of the 135 patients with mean age 49.8±18.0 years, 91(67.4%) were males and 44(32.6%) were females. The most common primary site of infection was the respiratory tract 63(46.7%). In-hospital mortality was noted in 52(38.5%) cases, while there were 83(61.5%) survivors. Serum levels of lactate and bicarbonate as well as urine output, fungal pathogens, septic shock and sequential organ failure were significantly associated with mortality (p<0.05).

Conclusions: Clinical and microbiological spectrum of community-acquired sepsis in a low- and middle-income country was found to be different from other regions of the world. Clinicians should keep these differences in mind while managing these critically ill patients.

Key Words: Sepsis, Septic shock, Critical care, Drug resistance, Fungi.

Author Biographies

Huzefa Jibril, Department of Medicine, The Aga Khan University, Karachi, Pakistan

Instructor, Department of Medicine

Safia Awan, Department of Medicine, The Aga Khan University, Karachi, Pakistan

Senior Instructor, Department of Medicine

Iffat Khanum, Department of Medicine, The Aga Khan University, Karachi, Pakistan

Assistant Professor, Department of Medicine

Published

2024-10-16

How to Cite

Jibril, H., Ali, S. A., Awan, S., & Khanum, I. (2024). Community-acquired sepsis in the medical intensive care unit – an experience from a lower-middle-income country. Journal of the Pakistan Medical Association, 74(11), 1942–1947. https://doi.org/10.47391/JPMA.11323

Issue

Section

Research Article

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