From Host Response to Microbiological Risk: Association of the RIN-IM Score with Culture-Positive Sepsis and Antimicrobial Resistance in Critically Ill Adults

Background/Objectives: Early identification of microbiologically confirmed sepsis and antimicrobial-resistant infection remains challenging in critically ill patients. The renal–inflammatory–nutritional–metabolic (RIN-IM) score integrates serum creatinine, the systemic immune-inflammation index, pan-immune inflammation value, serum albumin, and triglyceride–glucose index. This study investigated the association of the RIN-IM score with culture-positive sepsis and antimicrobial resistance phenotypes in critically ill adults.

Methods

This single-center retrospective cohort study included 318 adults with sepsis admitted to the intensive care unit between 1 January 2023 and 31 March 2026. The RIN-IM score was calculated from laboratory measurements obtained within 24 h and categorized as low (0–3), intermediate (4–6), or high risk (7–10). The primary outcome was culture-positive sepsis. Secondary analyses, restricted to patients with culture-positive sepsis, examined associations between RIN-IM and multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant phenotypes.