Comparison of Clinical Outcomes between Culture Positive and Culture Negative Sepsis and Septic Shock Patients

INTRODUCTION: Sepsis can be defined as organ dysfunction caused by a dysregulated host response to infection and is a leading cause of mortality among critically ill patients.(1) OBJECTIVES: To compare the clinical outcome, including mortality, ICU stay duration between culture positive and culture negative sepsis and septic shock patients. To compare the need of inotropic support, biochemical parameters and ABG in culture positive and negative sepsis and septic shock patients. MATERIALS AND METHODS: A prospective study was done on 100 patients presenting with sepsis and septic shock in Critical Care Unit of a tertiary care center. Data collected included need of inotropic support, lactate levels, PCT, PaO2 levels, TLC count, length of ICU stay and outcome in culture positive and culture negative patients. RESULTS: 58 (58%) patients were having culture positive status. Out of these patients 29(50%) had raised lactate levels, 26(45%) had decreased PaO2 levels, 23(40%) needed inotropic support, 33(56%) had raised serum PCT levels and 2(3.38%) patients had leucopenia. 20(35%) patients had mortality during treatment course. Median ICU stay was 10 days. 42(42%) patients were having culture negative status. Out of these patients 15(35%) had raised serum lactate levels, 12(30%) had decreased PaO2 levels, 18(42%) had raised serum PCT levels, 8(20%) needed inotropic support and 7(17.07%) had leucopenia. 10(25%) patients had mortality during treatment course. Median ICU stay was 7 days. CONCLUSION: Although culture-positive sepsis patients experienced higher mortality, longer ICU stays, more frequent use of critical care resources but culture negative patients with raised serum lactate levels, PCT levels, decreased PaO2 levels, Leucopenia, in need of inotropic support were also at risk of mortality.