suspicion-of-infection

Suspicion of Infection

This concept identifies when clinicians suspected infection based on clinical actions: systemic antibiotic administration combined with culture collection within a defined time window. It operationalizes the infection component of the Sepsis-3 definition (Seymour et al. 2016).

M4Bench Use

In M4Bench, target concept tables listed in the task configuration are removed or unavailable in the agent database. Use this skill as procedural guidance and derive the requested output from available source or intermediate tables; do not rely on a precomputed target table or bundled SQL script.

When to Use This Skill

• Building Sepsis-3 cohorts (infection component)
• Antibiotic stewardship research
• Time-to-treatment studies
• Infection onset timing
• Culture yield research

Definition Logic

Suspected infection requires BOTH:

1. Antibiotic administration (systemic, not topical)
2. Culture collection within time window:
   • Culture obtained up to 72h BEFORE antibiotic, OR
   • Culture obtained up to 24h AFTER antibiotic

Suspected Infection Time

The suspected_infection_time is defined as:

• The culture time if culture was obtained BEFORE antibiotic
• The antibiotic time if antibiotic was given BEFORE culture

This represents when infection was first clinically suspected.

Culture Matching Logic

Each antibiotic is matched to cultures in two directions:

Culture Before Antibiotic (Primary)

• Culture obtained within 72 hours before antibiotic start
• If multiple cultures, uses the EARLIEST culture before the antibiotic

Culture After Antibiotic (Secondary)

• Culture obtained within 24 hours after antibiotic start
• If multiple cultures, uses the EARLIEST culture after the antibiotic

Priority: Culture-before-antibiotic takes precedence when both exist.

Critical Implementation Notes

1. One Row Per Antibiotic: Each antibiotic prescription gets its own row, potentially matched to one culture. A single culture may be matched to multiple antibiotics.