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A study conducted in southern India found that sepsis occurs disproportionately among young people, primarily in rural areas, and that Gram-negative bacteria, viruses and tropical diseases are important causes, researchers say. reported today in the journal Clinical Infectious Diseases.
A team of researchers from India, the Netherlands, and the United Kingdom conducted a prospective observational study to gain insight into the causative agents and patient characteristics of patients with community-acquired sepsis in India, which accounts for 26% of sepsis-related deaths worldwide. Conducted from December 2018 to September 2022 at a tertiary care hospital in southern India, the research team enrolled adult patients within 24 hours of admission to the intensive care unit (ICU) who met international sepsis criteria. , microbiological, demographic, and outcome data were collected.
Of 4,000 patients screened at ICU admission, 1,000 (median age 55 years, 66% male) met inclusion criteria. Most patients live outside urban areas, 23.7% in towns and 46.5% in villages, but about half have no formal education and three-quarters work in primary industries. I work at Median ICU length of stay was 4 days, and in-hospital mortality was 24.1%.
Research fills important knowledge gaps
The causative agent could be identified in 54% of patients, of which 38% were bacterial, 18% viral, 10.6% leptospirosis, 4.1% typhus, 3.7% dengue, and 1.6% Kyasanur forest disease virus (KFDV). It was. Cases of sepsis caused by leptospirosis, typhus, dengue fever, and KFDV all showed seasonal variations around the monsoon period.
Among patients with bacterial sepsis, 43.9% of isolates were Gram-negative. The most frequently isolated species were Escherichia coli (52.3%), Klebsiella pneumoniae (23.3%), and Pseudomonas aeruginosa (5.3%). Further analysis revealed high levels of antibiotic resistance, with 75.8% of E. coli, 47.7% of Klebsiella pneumoniae, and 30% of Pseudomonas aeruginosa resistant to third-generation cephalosporins, and 10.1% and 13.6% carbapenem resistant, respectively. , 10.0%.
“This study provides an in-depth look at sepsis in southern India and fills an important knowledge gap regarding the real burden of sepsis in LMICs (low- and middle-income countries),” the study authors wrote. are. “These findings provide an important basis for strengthening capacity, optimizing resource allocation, and developing evidence-based treatment guidelines specifically tailored to South Asia, and highlight the importance of community epidemiology sepsis research in LMICs. Masu.”
