The Journal of infectious diseases
-
Multicenter Study Clinical Trial
Microbiologic findings and correlations with serum tumor necrosis factor-alpha in patients with severe sepsis and septic shock.
To understand the microbiology of sepsis and its relationship with tumor necrosis factor (TNF)-alpha, 444 septic patients were studied in a phase II clinical trial. In total, 270 (61%) 444 of episodes were microbiologically documented. The most common isolates were Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae. ⋯ Patients with a positive culture had significantly higher TNF-alpha levels (65.9 vs. 29.2 pg/mL, P=.0001). Patients with a pure gram-negative infection had significantly higher TNF-alpha levels than those with a pure gram-positive or mixed infection, especially in the late shock group (142.6, 64.0, and 52.8 pg/mL, respectively, P=.004). These results provide further support for the concept that patients with sepsis are a heterogeneous group that require more precise definition.