Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Unraveling Sepsis Epidemiology in a Low- and Middle-Income Intensive Care Setting Reveals the Alarming Burden of Tropical Infections and Antimicrobial Resistance: A Prospective Observational Study (MARS-India).
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03727243 (Molecular Diagnosis and Risk Stratification of Sepsis in India), which is not on this map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Molecular Diagnosis and Risk Stratification of Sepsis in India
Who cites it
7 citing papers in PubMed.
- Host response signatures across sepsis aetiologies in India: a single centre observational study.The Lancet regional health. Southeast Asia · 2026Article
- Epidemiology, Management, and Outcomes of Patients Hospitalized With Community-Acquired Infection in a Resource-Limited Setting in Southeast Asia: A Prospective Observational Study.Open forum infectious diseases · 2026Article
- Data-driven spatial-temporal framework for exploring the heterogeneity and temporality of sepsis.Chinese medical journal · 2026Review
- Thirty-five years of evolving inflammatory paradigms in sepsis (1991-2025): a comprehensive mapping of immune dysregulation research, anti-inflammatory targets, and translational barriers.Frontiers in immunology · 2026Article
- The relationship between admission Braden score and poor prognosis in Sepsis patients: evidence from the MIMIC-III database.BMC infectious diseases · 2025Article
- Leptospirosis-Improving Healthcare Outcomes for a Neglected Tropical Disease.Open forum infectious diseases · 2025Review
- Neonatal Sepsis in Low-Resource Emergency Settings: Evidence-Based Strategies for Early Recognition and Management.Sage open pediatricsReview
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Authors and funding
15 authors.
Funding
Abstract
backgroundOur study addresses the sepsis research gap in lower- and middle-income countries, notably India. Here, we investigate community-acquired sepsis comprehensively and explore the impact of tropical microbiology on etiology and outcomes.
methodsMARS-India was a prospective observational study from December 2018 to September 2022 in a tertiary-care hospital in South India. Adult patients within 24 hours of intensive care unit (ICU) admission meeting the Sepsis-3 definition were enrolled, with 6 months of follow-up.
resultsMore than 4000 patients were screened on ICU admission, with 1000 unique patients meeting the inclusion criteria. Median age was 55 (interquartile range, 44-65) years, with a male preponderance (66%). Almost half the cohort resided in villages (46.5%) and 74.6% worked in the primary sector. Mortality in-hospital was 24.1%. Overall, about 54% had confirmed microbiological diagnosis and >18% had a viral cause of sepsis. Surprisingly, we identified leptospirosis (10.6%), scrub typhus (4.1%), dengue (3.7%), and Kyasanur forest disease (1.6%) as notable causes of sepsis. All of these infections showed seasonal variation around the monsoon. In community-acquired infections, we observed substantial resistance to third-generation cephalosporins and carbapenems.
conclusionsIn India, sepsis disproportionally affects a younger and lower-socioeconomic demographic, yielding high mortality. Tropical and viral sepsis carry a significant burden. Analyzing local data, we pinpoint priorities for public health and resources, offering valuable insights for global sepsis research. Clinical Trials Registration. NCT03727243.
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