Risk Factors and Outcome of Sepsis in Traumatic Patients and Pathogen Detection Using Metagenomic Next-Generation Sequencing

Objective. Sepsis, a life-threatening clinical syndrome, is a leading cause of mortality after experiencing multiple traumas. Once diagnosed with sepsis, patients should be given an appropriate empiric antimicrobial treatment followed by the specific antibiotic therapy based on blood culture due to...

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Published in:The Canadian journal of infectious diseases & medical microbiology 2022-04, Vol.2022, p.2549413-10
Main Authors: Tong, Yiqing, Zhang, Jianming, Fu, Yimu, He, Xingxing, Feng, Qiming
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Antiinfectives and antibacterials
Ascites
Bacterial infections
Blood cell count
Blood culture
Blood pressure
Blood transfusion
Body temperature
Bronchus
Cardiovascular disease
Coma
Comparative analysis
Complications and side effects
Consent
Creatinine
Diagnosis
DNA sequencing
Dopamine
E coli
Ethylenediaminetetraacetic acid
Failure analysis
Heart beat
Heart rate
Hematocrit
Hypotension
Immune system
Infection
Infectious diseases
Injuries
Intensive care
Lavage
Leukocytes (neutrophilic)
Mechanical ventilation
Medical research
Medicine, Experimental
Metagenomics
Mortality
Multivariate analysis
Next-generation sequencing
Nosocomial infections
Nucleotide sequencing
Pathogens
Patient outcomes
Patients
Peripheral blood
Physiology
Regression analysis
Risk analysis
Risk factors
Sepsis
Septic shock
Sputum
Trauma
Urea
Wounds and injuries
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Summary:Objective. Sepsis, a life-threatening clinical syndrome, is a leading cause of mortality after experiencing multiple traumas. Once diagnosed with sepsis, patients should be given an appropriate empiric antimicrobial treatment followed by the specific antibiotic therapy based on blood culture due to its rapid progression to tissue damage and organ failure. In this study, we aimed to analyze the risk factors and outcome of sepsis in traumatic patients and to investigate the performance of metagenomic next-generation sequencing (mNGS) compared with standard microbiological diagnostics in post-traumatic sepsis. Methods. The study included 528 patients with multiple traumas among which there were 142 cases with post-traumatic sepsis. Patients’ demographic and clinical data were recorded. The outcome measures included mortality during the emergency intensive care unit (EICU), EICU length of stay (LOS), all-cause 28-day mortality, and total ventilator days in 28 days after admission. A total of 89 blood samples from 89 septic patients underwent standard microbiological blood cultures and 89 samples of peripheral blood (n = 21), wound secretion (n = 41), bronchoalveolar lavage fluid (BALF) (19), ascites (n = 5), and sputum (n = 3) underwent mNGS. Pathogen detection was compared between standard microbiological blood cultures and mNGS. Results. The sepsis group and non-sepsis group exhibited significant differences regarding shock on admission, blood transfusion, mechanical ventilation, body temperature, heart rate, WBC count, neutrophil count, hematocrit, urea nitrogen, creatinine, CRP, D-D dimer, PCT, scores of APACHE II, sequential organ failure assessment (SOFA), and Injury Severity Score (ISS) on admission to the EICU, and Multiple Organ Dysfunction Syndromes (MODS) (P
ISSN:1712-9532
1918-1493
DOI:10.1155/2022/2549413