Gram-negative bloodstream infections and sepsis: risk factors, screening tools and surveillance

Abstract

Introduction and background: Incidence of gram-negative bloodstream infections (GNBSIs) and sepsis are rising in the UK. Healthcare-associated risk factors have been identified that increase the risk of infection and associated mortality. Current research is focused on identifying high-risk patients and improving the methods used for surveillance.

Sources of data: Comprehensive literature search of the topic area using PubMed (Medline). Government, professional and societal publications were also reviewed.

Areas of agreement: A range of healthcare-associated risk factors independently associate with the risk of GNBSIs and sepsis.

Areas of controversy: There are calls to move away from using simple comorbidity scores to predict the risk of sepsis-associated mortality, instead more advanced multimorbidity models should be considered.

Growing points and areas for developing research: Advanced risk models should be created and evaluated for their ability to predict sepsis-associated mortality. Investigations into the accuracy of NEWS2 to predict sepsis-associated mortality are required.

Keywords: bloodstream infection; gram-negative; mortality; sepsis.