Baykara, NurArslantas, Mustafa KemalHancı, VolkanÇağlayan, ÇiğdemDemirağ, KubilayBaydemir, CananÜnal, Necmettin2024-03-252024-03-252018-03-12Baykara, N. vd. (2018). ''Epidemiology of sepsis in intensive care units in Turkey: A multicenter, point-prevalence study''. Critical Care, 22.1466-609Xhttps://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2013-1https://hdl.handle.net/11452/40603Background: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. Methods: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded. Results: Of the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1: 4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients. Conclusions: A high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality.eninfo:eu-repo/semantics/openAccessIntensive careSepsisCarbapenem resistancePoint prevalenceTurkeySeptic shockRisk-factorsHospital mortalityPatient mortalityInfectionStatesDefinitionsOutcomesOrganismsTrendsGeneral & internal medicineAcinetobacter infectionsAgedAPACHECross-sectional studiesFemaleHumansIntensive care unitsKlebsiella infectionsLogistic modelsMaleMiddle agedMonte carlo methodOrgan dysfunction scoresPseudomonas infectionsSepsisShock, septicStatisticsNonparametricSystemic inflammatory response syndromeTurkeyArticle0004306177000012-s2.0-850454121812229656714https://doi.org/10.1186/s13054-018-2013-1Critical care medicineIntensive Care Unit; Sepsis (Diptera); Septic ShockCarbapenemAcinetobacterAdultAge distributionAgedAntibiotic resistanceAPACHEArticleCandidiasisFemaleHumanInfectionIntensive care unitKlebsiellaMajor clinical studyMaleMalignant neoplasmMortality rateNurse patient ratioPrevalencePriority journalPseudomonasRenal replacement therapyRespiratory tract infectionRisk factorSepsisSeptic shockSequential organ failure assessment scoreSystemic inflammatory response syndromeTurkey (republic)Very elderlyAcinetobacter infectionClinical trialCross-sectional studyIntensive care unitKlebsiella infectionMiddle agedMonte Carlo methodMortalityMulticenter studyNonparametric testOrgan dysfunction scoreOrganization and managementPseudomonas infectionSeptic shockStatistical modelStatistics and numerical dataSystemic inflammatory response syndromeTurkey (bird)1364-8535