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dc.contributor.authorNygård, Siri Tandbergeng
dc.contributor.authorLangeland, Ninaeng
dc.contributor.authorFlaatten, Hanseng
dc.contributor.authorFanebust, Runeeng
dc.contributor.authorHaugen, Oddbjørneng
dc.contributor.authorSkrede, Steinareng
dc.date.accessioned2014-09-16T13:26:57Z
dc.date.available2014-09-16T13:26:57Z
dc.date.issued2014-03-04eng
dc.identifier.issn1471-2334eng
dc.identifier.urihttp://hdl.handle.net/1956/8495
dc.description.abstract<p>Background: Severe sepsis is recognized as an inflammatory response causing organ dysfunction in patients with infection. Antimicrobial therapy is the mainstay of treatment. There is an ongoing demand for local surveillance of sepsis aetiology and monitoring of empirical treatment recommendations. The present study was established to describe the characteristics, quality of handling and outcome of patients with severe sepsis admitted to a Norwegian university hospital.</p> <p>Methods: A one year prospective, observational study of adult community acquired case-defined severe sepsis was undertaken. Demographics, focus of infection, microbiological findings, timing and adequacy of empirical antimicrobial agents were recorded. Clinical diagnostic practice was evaluated. Differences between categorical groups were analysed with Pearson&rsquo;s chi-squared test. Predictors of in-hospital mortality were identified in a multivariate stepwise backward logistic regression model.</p> <p>Results: In total 220 patients were identified, yielding an estimated annual incidence of 0.5/1000 inhabitants. The focus of infection was established at admission in 69%. Respiratory tract infection was present in 52%, while genitourinary, soft tissue and abdominal infections each were found in 12-14%. Microbiological aetiology was identified in 61%; most prevalent were Streptococcus pneumoniae, Escherichia coli and Staphylococcus aureus. Independent predictors of in-hospital mortality were malignancy, cardiovascular disease, endocarditis, abdominal infections, undefined microbiological aetiology, delay in administration of empirical antimicrobial agents &ge; 6 hours and use of inadequate antimicrobial agents. In patients &ge; 75 years, antimicrobial therapy was less in compliance with current recommendations and more delayed.</p> <p>Conclusions: Community acquired severe sepsis is common. Initial clinical aetiology is often revised. Compliance with recommendations for empirical antimicrobial treatment is lowest in elderly patients. Our results emphasizes that quick identification of correct source of infection, proper sampling for microbiological analyses, and fast administration of adequate antimicrobial agents are crucial points in the management of severe sepsis.</p>en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/17877" target="blank"> The epidemiology and characteristics of sepsis in Norwegian hospitals</a>
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0eng
dc.subjectSevere sepsiseng
dc.subjectEpidemiologyeng
dc.subjectAetiologyeng
dc.subjectAntimicrobial therapyeng
dc.subjectComplianceeng
dc.subjectOutcomeeng
dc.titleAetiology, antimicrobial therapy and outcome of patients with community acquired severe sepsis: a prospective study in a Norwegian university hospitaleng
dc.typeJournal articleeng
dc.date.updated2014-04-04T06:57:41Z
dc.description.versionPeer Reviewed
dc.rights.holderCopyright 2014 Nygård et al.; licensee BioMed Central Ltd.
dc.rights.holderSiri Tandberg Nygård et al.; licensee BioMed Central Ltd.eng
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitleBMC Infectious Diseaseseng
bibo.volume14eng
bibo.number121eng
bora.accessRightsinfo:eu-repo/semantics/openAccesseng
dc.identifier.cristinID1150100eng
dc.identifier.doi10.1186/1471-2334-14-121


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Except where otherwise noted, this item's license is described as Attribution CC BY