Positive pathogens in stool could predict the clinical outcomes of sepsis-associated acute kidney injury in critical ill patient

Sci Rep. 2024 May 16;14(1):11227. doi: 10.1038/s41598-024-62136-6.

Abstract

In this study, we sought to evaluate the influence of positive pathogens in stool (PPS) on clinical outcomes in critical ill patients with Sepsis-associated acute kidney injury (S-AKI) from intensive care unit. Our sample consisted of 7338 patients, of whom 752 (10.25%) had PPS. We found that the presence of Clostridium difficile (C. difficile) and protists in stool samples was correlated with survival during hospitalization, as well as 30-day and 90-day survival. Interestingly, there was no significant difference in overall survival and 30-day in-hospital survival between the PPS group and the negative pathogens in stool (NPS) control group. However, the cumulative incidence of 90-day infection-related mortality was significantly higher in the PPS group (53 vs. 48%, P = 0.022), particularly in patients with C. difficile in their stool specimens. After adjusting for propensity scores, the results also have statistical significance. These findings suggest that PPS may affect the 90-days survival outcomes of S-AKI, particularly in patients with C. difficile and protists in their stool samples. Further research is warranted to further explore these associations.

Keywords: Clostridium difficile; Acute kidney injury; Bacterial infection; Stool pathogens.

MeSH terms

  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / microbiology
  • Acute Kidney Injury* / mortality
  • Aged
  • Clostridioides difficile* / isolation & purification
  • Critical Illness*
  • Feces* / microbiology
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prognosis
  • Sepsis* / complications
  • Sepsis* / microbiology
  • Sepsis* / mortality