Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009–2018 - Summary - MDSpire

Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009–2018

  • By

  • Jack Zhenhe Zhang

  • Chun Hei Chan

  • Lok Ching Chang

  • Lok Ching Sandra Chiu

  • Pauline Yeung Ng

  • Manimala Dharmangadan

  • Eunise Ho

  • Steven Ling

  • Man Yee Man

  • Ka Man Fong

  • Ting Liong

  • Alwin Wai Tak Yeung

  • Ka Fai Au

  • Jacky Ka Hing Chan

  • Michele Tang

  • Katy Hoi Ki Li

  • William Ka Kei Wu

  • Wai Tat Wong

  • Peng Wu

  • Benjamin J Cowling

  • Kwok Ming Ho

  • Anna Lee

  • Chanu Rhee

  • Lowell Ling

  • December 17, 2025

  • 0 min

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Objective:

To assess the 10-year longitudinal trends in early sepsis management bundle adherence rates and their association with survival in adults with community-acquired sepsis in Hong Kong.

Key Findings:
  • Full bundle adherence increased from 0.2% in 2009 to 1.2% in 2018 (P < .001).
  • Empirical broad-spectrum antibiotic administration increased at a rate of +9.8%/y, outpacing antimicrobial resistance prevalence (+5.2%/y).
  • Full bundle adherence was associated with reduced mortality (ORadj, 0.75 [95% CI, .65–.86]).
  • Blood culture collection and lactate measurement were also linked to reduced mortality (ORadj, 0.88 and ORadj, 0.85 respectively).
Interpretation:

Basic sepsis care implementation remains challenging in high-income settings like Hong Kong. While adherence to sepsis bundles improved over time, the increase in broad-spectrum antibiotic use raises concerns about antimicrobial resistance and necessitates careful management.

Limitations:
  • Limited uptake of individual bundle elements despite overall adherence improvements, which may affect overall outcomes.
  • Lack of regular audits on sepsis care adherence in public hospitals, potentially hindering quality improvement efforts.
Conclusion:

Efforts should focus on ensuring adherence to sepsis management bundles while prioritizing appropriate treatments to improve survival outcomes, including regular audits and targeted interventions.

Original Source(s)

Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009–2018

  • by Jack Zhenhe Zhang, Chun Hei Chan, Lok Ching Chang, Lok Ching Sandra Chiu, Pauline Yeung Ng, Manimala Dharmangadan, Eunise Ho, Steven Ling, Man Yee Man, Ka Man Fong, Ting Liong, Alwin Wai Tak Yeung, Ka Fai Au, Jacky Ka Hing Chan, Michele Tang, Katy Hoi Ki Li, William Ka Kei Wu, Wai Tat Wong, Peng Wu, Benjamin J Cowling, Kwok Ming Ho, Anna Lee, Chanu Rhee, Lowell Ling

  • December 17, 2025

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