ArticleThe Journal of international medical research2026
Clinical outcomes and inflammatory profiles in culture-positive sepsis: A retrospective cohort study.
Article in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
ObjectiveTo describe clinical outcomes and inflammatory profiles in patients with culture-positive sepsis identified using Sepsis-3 criteria and to explore their association with bacterial Gram stain status.MethodsA retrospective cohort study was conducted in adult patients with sepsis hospitalized at a single-center hospital in East Java, Indonesia, in 2023. Patients were identified using Sepsis-3 criteria and included if blood cultures were obtained at admission. Data collected included blood culture results, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, comorbidities, length of hospital stay, and in-hospital mortality. Patients were grouped according to bacterial Gram stain status. Group differences were analyzed using the chi-square test for categorical variables and the Mann-Whitney U test for continuous variables. Multivariate logistic regression was performed to identify factors associated with mortality.ResultsAmong 172 patients clinically diagnosed with sepsis, blood culture was positive in 46 cases (26.7%), indicating that most patients (73.3%) had culture-negative sepsis. Among culture-positive cases, gram-positive organisms predominated (n = 37), whereas gram-negative pathogens were less frequently isolated (n = 9). Increased inflammatory burden, reflected by a higher admission neutrophil-to-lymphocyte ratio, was associated with worse clinical outcomes. In multivariate analysis, gram-negative infection (adjusted odds ratio = 4.00, 95% confidence interval: 1.05-15.30), higher neutrophil-to-lymphocyte ratio (adjusted odds ratio = 1.06 per unit; 95% confidence interval: 1.01-1.11), and acute kidney injury (adjusted odds ratio = 5.30, 95% confidence interval: 1.73-16.50) were independently associated with in-hospital mortality.ConclusionCulture-negative sepsis was common, likely influenced by early antibiotic use. Gram-positive pathogens predominated among culture-positive cases, whereas gram-negative infections were associated with worse clinical outcomes. Elevated neutrophil-to-lymphocyte ratio and acute kidney injury independently predicted in-hospital mortality. These findings support the need for multimodal sepsis assessment integrating clinical judgment and laboratory markers rather than relying solely on culture results.
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