title: Positive blood culture is not associated with increased mortality in patients with sepsis-induced acute respiratory distress syndrome.
abstract: OBJECTIVE
  Previous studies have demonstrated that positive blood culture could contribute to poorer outcomes in patients with pneumonia. However, the impact of positive blood culture on the outcomes of patients with sepsis-induced acute respiratory distress syndrome (ARDS) has not been evaluated.
  
  
  METHODS
  An observational study that prospectively screened 4861 patients admitted to medical or surgical intensive care units (ICUs) of a tertiary referral centre was performed.
  
  
  RESULTS
  Among 4861 admitted patients, 146 diagnosed with sepsis-induced ARDS were enrolled (mean age: 66.1 years). Lower PaO2 /FiO2 , decreased respiratory system compliance, and higher lung injury scores (LIS) on the day of ARDS diagnosis were associated with positive blood cultures (n = 68) rather than negative blood cultures (n = 78). There was no relationship between positive blood culture and in-hospital mortality. Kaplan-Meier estimates also revealed that positive blood culture was not associated with 60-day mortality but with an increased length of stay in the hospital and in the ICU (P = 0.007 and P = 0.016, respectively). Using multivariate logistic regression, higher LIS was independently associated with positive blood culture. In addition, chronic pulmonary disease, lower platelet count, higher LIS, and the development of shock on the diagnosis of ARDS, were independent risk factors for in-hospital mortality.
  
  
  CONCLUSIONS
  This study suggests that the presence of positive blood culture is not associated with increased mortality; however, the mean durations of hospital and ICU stays in patients with sepsis-induced ARDS are increased.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan.
authors.forename: Szu-Chun
authors.initials: SC
authors.lastname: Yang
authors.forename: Kuang-Ming
authors.initials: KM
authors.lastname: Liao
authors.forename: Chang-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000097:blood*; D005260:Female; D006090:Gram-Negative Bacteria / Q000276:immunology / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000150:complications; D006094:Gram-Positive Bacteria / Q000276:immunology / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000150:complications; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000382:microbiology* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis*; D012698:Serologic Tests; D015996:Survival Rate
chemical_list: D000942:Antigens, Bacterial
keywords: acute respiratory distress syndrome; bacteraemia; infection and inflammation; lung injury; mortality