{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:17:19Z","timestamp":1787926639323,"version":"build-2784847793"},"reference-count":26,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe clinical outcomes and inflammatory profiles in patients with culture-positive sepsis identified using Sepsis-3 criteria and to explore their association with bacterial Gram stain status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted in adult patients with sepsis hospitalized at a single-center hospital in East Java, Indonesia, in 2023. Patients were identified using Sepsis-3 criteria and included if blood cultures were obtained at admission. Data collected included blood culture results, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, comorbidities, length of hospital stay, and in-hospital mortality. Patients were grouped according to bacterial Gram stain status. Group differences were analyzed using the chi-square test for categorical variables and the Mann\u2013Whitney U test for continuous variables. Multivariate logistic regression was performed to identify factors associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 172 patients clinically diagnosed with sepsis, blood culture was positive in 46 cases (26.7%), indicating that most patients (73.3%) had culture-negative sepsis. Among culture-positive cases, gram-positive organisms predominated (n\u2009=\u200937), whereas gram-negative pathogens were less frequently isolated (n\u2009=\u20099). Increased inflammatory burden, reflected by a higher admission neutrophil-to-lymphocyte ratio, was associated with worse clinical outcomes. In multivariate analysis, gram-negative infection (adjusted odds ratio = 4.00, 95% confidence interval: 1.05\u201315.30), higher neutrophil-to-lymphocyte ratio (adjusted odds ratio = 1.06 per unit; 95% confidence interval: 1.01\u20131.11), and acute kidney injury (adjusted odds ratio = 5.30, 95% confidence interval: 1.73\u201316.50) were independently associated with in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Culture-negative sepsis was common, likely influenced by early antibiotic use. Gram-positive pathogens predominated among culture-positive cases, whereas gram-negative infections were associated with worse clinical outcomes. Elevated neutrophil-to-lymphocyte ratio and acute kidney injury independently predicted in-hospital mortality. These findings support the need for multimodal sepsis assessment integrating clinical judgment and laboratory markers rather than relying solely on culture results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261454273","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T12:23:37Z","timestamp":1787660617000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and inflammatory profiles in culture-positive sepsis: A retrospective cohort study"],"prefix":"10.1177","volume":"54","author":[{"given":"Nuril Farid","family":"Abshori","sequence":"first","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University Malang"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoirunnisa Luthfiyyah","family":"Andarwati","sequence":"additional","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatahillah Tsabit","family":"Fatoni","sequence":"additional","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tio Rizki","family":"Fauzi","sequence":"additional","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achmad Zainudin","family":"Arif","sequence":"additional","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University Malang"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwal Reza","family":"Ahdi","sequence":"additional","affiliation":[{"name":"Maulana Malik Ibrahim Islamic State University Malang"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-8240","authenticated-orcid":false,"given":"Muhammad","family":"Habiburrahman","sequence":"additional","affiliation":[{"name":"Universitas Indonesia"},{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06151-x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3889\/oamjms.2021.7780"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-020-01974-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-018-0398-x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04750-w"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.856039"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13010079"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.15419\/bmrat.v11i6.895"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.10.023"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1336456"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000002681"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1696"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.05.016"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1373\/jalm.2018.028274"},{"key":"e_1_3_3_18_2","unstructured":"Tobin EH Zahra F. 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