Epidemiology, Management, and Outcomes of Patients Hospitalized With Community-Acquired Infection in a Resource-Limited Setting in Southeast Asia: A Prospective Observational Study - Summary - MDSpire
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Epidemiology, Management, and Outcomes of Patients Hospitalized With Community-Acquired Infection in a Resource-Limited Setting in Southeast Asia: A Prospective Observational Study
To assess the frequency of sepsis, causative infectious etiologies, management, risk factors, and infection-related outcomes among patients hospitalized for community-acquired infections in rural Thailand, addressing significant gaps in existing literature.
Key Findings:
Out of 1445 screened patients, 940 were enrolled, with a median age of 60 years and 42% having preexisting diabetes. Broad-spectrum antibiotics were administered to over 95% of patients, and lactate measurement was performed in 43% of patients with sepsis.
66% of patients met sepsis criteria, with common critical illnesses including respiratory failure (33%) and shock (21%).
Tropical infections included melioidosis (8%) and leptospirosis (4%), with gram-negative organisms causing 81% of bacteremia.
20% of patients with sepsis died by 28 days, with sepsis-associated acute kidney injury (SA-AKI) linked to increased mortality.
Interpretation:
Sepsis is prevalent among hospitalized patients with community-acquired infections in rural Southeast Asia, associated with significant morbidity and mortality, highlighting the need for tailored management strategies to improve clinical outcomes.
Limitations:
The study was conducted in two hospitals, which may limit generalizability to other regions.
Follow-up for mortality was not possible for all discharged patients, potentially introducing selection bias.
Conclusion:
The findings underscore the high burden of sepsis in resource-limited settings and the importance of identifying modifiable risk factors like SA-AKI to improve patient outcomes.
