Nagdev Govind, Chavan Gajanan, Sahu Gaurav
Department of Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Sep 24;14(9):e29528. doi: 10.7759/cureus.29528. eCollection 2022 Sep.
Background Sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. Septic shock, multi-organ dysfunction, and death occur in severe cases with reduced blood flow to vital organs. Sepsis contributes to 15-20% of all global deaths. Through this study, we intend to evaluate the clinical profile and study the common blood investigatory panels along with organisms causing sepsis in patients presenting with sepsis in the emergency department during the COVID pandemic. In addition, the study was also done to estimate the prevalence of sepsis and compare patients having sepsis with serum lactate, sepsis with Systemic Inflammatory Response Syndrome (SIRS) criteria, and sepsis with quick Sepsis Related Organ Failure Assessment (qSOFA) score. Method Observational retrospective study to evaluate patients presenting with sepsis diagnosed by the Third International Consensus Definitions for Sepsis and Septic Shock" criteria presenting to the emergency department of Acharya Vinoba Bhave Rural Hospital (AVBRH) affiliated to Jawaharlal Nehru Medical College (JNMC), Wardha during COVID pandemic (June 2020-June 2021). Results The majority of the patients presented with fever (42%), and very few presented with altered mental status (8%). Seventy-four percent of the study population did not show any bacterial growth on blood culture, but out of the remaining 26%, blood culture, , , and were the significant microbes. Amongst qSOFA, SIRS criteria, and serum lactate as a screening tool for sepsis, SIRS is the most sensitive for screening sepsis patients. Conclusion were the major contributors in the development of sepsis in COVID-19-associated infection. The presence of raised leukocyte counts and serum lactate should alarm clinicians of possible sources of infection. The timely initiation, rapid de-escalation of empirical antibiotics, and strict compliance with infection control practices should be accomplished to reduce the occurrence of multidrug resistance organisms.
脓毒症被定义为因宿主对感染的反应失调而导致的危及生命的器官功能障碍。在严重病例中,由于重要器官的血流减少,会发生感染性休克、多器官功能障碍和死亡。脓毒症导致全球所有死亡人数的15%至20%。通过本研究,我们旨在评估新冠疫情期间急诊科脓毒症患者的临床特征,研究常见的血液检查项目以及导致脓毒症的病原体。此外,该研究还旨在估计脓毒症的患病率,并比较脓毒症患者与血清乳酸水平、符合全身炎症反应综合征(SIRS)标准的脓毒症患者以及脓毒症快速相关器官功能衰竭评估(qSOFA)评分的患者。方法:采用观察性回顾性研究,评估根据“脓毒症和感染性休克第三次国际共识定义”标准诊断为脓毒症的患者,这些患者在新冠疫情期间(2020年6月至2021年6月)就诊于贾瓦哈拉尔尼赫鲁医学院(JNMC)附属的阿查里亚·维诺巴·巴韦农村医院(AVBRH)急诊科。结果:大多数患者表现为发热(42%),很少有患者表现为精神状态改变(8%)。74%的研究人群血培养未显示任何细菌生长,但在其余26%中,血培养中 、 、 是重要的微生物。在qSOFA、SIRS标准和血清乳酸作为脓毒症筛查工具中,SIRS对脓毒症患者筛查最敏感。结论: 在新冠病毒相关感染所致脓毒症的发生中起主要作用。白细胞计数和血清乳酸升高应提醒临床医生注意可能的感染源。应及时启动、迅速降阶梯使用经验性抗生素,并严格遵守感染控制措施,以减少多重耐药菌的发生。