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We employed sepsis stewardship and herein report an observational study. Study subjects were patients admitted to the Departments of Surgery\/Chest Surgery from 2011 through 2018 with a diagnosis of sepsis and a SOFA score of 2 or more. Our sepsis stewardship methods included antimicrobial and diagnostic stewardship and infection control. We determined the primary endpoint as in-hospital death and the secondary endpoint as the annual trend of the risk-adjusted mortality ratio (RAMR). For mortality, we performed logistic regression analysis based on SOFA score, age, sex, comorbid disease, and the presence of methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) and extended-spectrum beta-lactamase inhibitor\u2013producing bacteria. In a total of 457 patients, two factors were significant predictors for fatality, i.e., SOFA score of 9 or more with an odds ratio (OR) 4.921 and 95% confidence interval [95% CI] 1.968\u201312.302 (<jats:italic>P<\/jats:italic> = 0.001) and presence of MRSA with an OR 1.83 and 95% CI 1.003\u20133.338 (<jats:italic>P<\/jats:italic> = 0.049). RAMR showed a decrease during the study years (<jats:italic>P<\/jats:italic> &lt; 0.05). Early detection of MRSA may help patients survive surgical sepsis-3. Thus, MRSA-oriented diagnosis may play a role in expediting treatment with anti-MRSA antimicrobials.<\/jats:p>","DOI":"10.1007\/s10096-020-04037-w","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T01:02:21Z","timestamp":1600650141000},"page":"535-540","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mortality related to drug-resistant organisms in surgical sepsis-3: an 8-year time trend study using sequential organ failure assessment scores"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-8455","authenticated-orcid":false,"given":"Junichi","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Otani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Miyatake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Ishimitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Nakahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"4037_CR1","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1007\/s00134-014-3474-6","volume":"40","author":"I Cavazzuti","year":"2014","unstructured":"Cavazzuti I, Serafini G, Busani S, Rinaldi L, Biagioni E, Buoncristiano M et al (2014) Early therapy with IgM-enriched polyclonal immunoglobulin in patients with septic shock. 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