{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:55:54Z","timestamp":1792155354147,"version":"4.4.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005815","name":"Firland Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005815","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In many resource-limited settings, hospitalization for community-acquired infection is common, but data regarding illness severity, etiology, and morbidity remain sparse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study from May 2022 to August 2023 at 2 hospitals in northeast Thailand. Adults hospitalized with community-acquired infection were enrolled within 24\u2005hours of admission and followed up to 28 days. We identified patients meeting sepsis criteria and assessed related epidemiology, management, and mortality risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1445 patients screened, 940 were enrolled. The median age was 60 years and preexisting diabetes mellitus was common (42%). Sixty-six percent of patients met sepsis criteria. Blood cultures and broad-spectrum antibiotics on admission were common (both &amp;gt;95%), although lactate measurement was performed in 43% of patients with sepsis. In patients with sepsis, critical illness outside the intensive care unit was common on medical ward admission, including respiratory failure (33%) and shock (21%). Tropical etiologies of infection included melioidosis (8%) and leptospirosis (4%), and gram-negative organisms accounted for 81% of bacteremia. Twenty percent of patients with sepsis died by 28 days. Sepsis-associated acute kidney injury (SA-AKI) on admission was independently associated with mortality (adjusted odds ratio, 2.07; 95% CI, 1.30\u20133.29; P = .002), and patients with SA-AKI had worse survival (P &amp;lt; .001) than those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In rural Southeast Asia, sepsis is common among patients hospitalized with infection and associated with substantial morbidity and mortality. Distinct pathogens and broad-spectrum antibiotics are common, even in the absence of sepsis. We identified several modifiable risk factors of death, including SA-AKI, potentially influencing initial management in similar settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag022","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:34:51Z","timestamp":1768048491000},"source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology, Management, and Outcomes of Patients Hospitalized With Community-Acquired Infection in a Resource-Limited Setting in Southeast Asia: A Prospective Observational Study"],"prefix":"10.1093","volume":"13","author":[{"given":"Rungnapa","family":"Phunpang","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prapassorn","family":"Poolchanuan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor D","family":"Coston","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adul","family":"Dulsuk","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sopha","family":"Saeyang","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boonthanom","family":"Moonmueangsan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narongchai","family":"Sangsa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Roi Et Hospital , Roi Et ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sermchart","family":"Chinnakarnsawas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Roi Et Hospital , Roi Et ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachan","family":"Janon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mukdahan Hospital , Mukdahan 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