Culture-Negative and Culture-Positive Sepsis or Septic Shock

Incidence of sepsis and septic shock has been increasing consistently, and the morbidity and mortality associated with this is an area of concern. Mortality from sepsis and septic shock is quite high, ranging between 20 to 40%. Guidelines for sepsis and septic shock recommend the application of broad-spectrum antibiotics. There is clinical evidence that time to effective antibiotic therapy could reduce patient mortality.

According to the Third International Consensus Definitions for Sepsis and Septic Shock, sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis without a microbiologically documented infection is called culture-negative sepsis/septic shock. The proportion of culture-negative cases is between 28 to 49% among all patients with sepsis.

Culture-negative sepsis poses significant challenges to clinicians and microbiologists. It differs fundamentally from culture-positive sepsis or septic shock in terms of pathophysiology, epidemiology, and treatment responses.