title: Community- versus nosocomial-acquired severe sepsis and septic shock in patients admitted to a tertiary intensive care in Saudi Arabia, etiology and outcome.
abstract: BACKGROUND
  Sepsis syndrome is a major worldwide cause of morbidity and mortality. While community-acquired severe sepsis and septic shock constitutes a major cause of admission to the intensive care unit, hospital-acquired severe sepsis and septic shock remain major preventable causes of ICU admission. This study evaluates the rate, etiology, complication and outcome of community- and hospital-acquired sepsis in a tertiary care hospital in Saudi Arabia.
  
  
  METHODS
  This is a retrospective evaluation of all admissions with severe sepsis and septic shock to a general intensive care unit over a period of six months.
  
  
  RESULTS
  A total number of 96 patients were included, which represented 15% of the total number of admissions during the study period. The mean age was 57.4 (SD 21). Sixty percent of cases were due to hospital-acquired infections, and 40% were community-acquired. The majority of the infections acquired in the hospital occurred in medical wards and intensive care units (27% and 21%, respectively). At least one co-morbid condition was present in 94% of the sample patients, with cardiovascular disease and diabetes being the most frequently encountered disorders (58%). Both community and hospital-acquired severe sepsis and septic shock carry very high mortality (58%). The ICU length of stay was significantly longer for hospital and ICU acquired infections.
  
  
  CONCLUSIONS
  Both community and hospital-acquired infections carry high mortality. Hospital-acquired severe sepsis is frequent in medical wards and ICUs, and measures to further evaluate risk factors are prudent.
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: baharoon@hotmail.com.
authors.forename: Salim
authors.initials: S
authors.lastname: Baharoon
authors.affiliation: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Ayman
authors.initials: A
authors.lastname: Telmesani
authors.affiliation: Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: King Saud Chest Specialty Hospital, Riyadh, Saudi Arabia.
authors.forename: Eiman
authors.initials: E
authors.lastname: Alsafi
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Sameerah
authors.initials: S
authors.lastname: Aljohani
authors.affiliation: Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Mahmoud
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Hamdan
authors.initials: H
authors.lastname: Al-Jahdali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Community acquired severe sepsis; Hospital acquired severe sepsis; Outcome