Author:
Buetti Niccolò,Tabah Alexis,Loiodice Ambre,Ruckly Stéphane,Aslan Abdullah Tarik,Montrucchio Giorgia,Cortegiani Andrea,Saltoglu Nese,Kayaaslan Bircan,Aksoy Firdevs,Murat Akova,Akdoğan Özlem,Saracoglu Kemal Tolga,Erdogan Cem,Leone Marc,Ferrer Ricard,Paiva José-Artur,Hayashi Yoshiro,Ramanan Mahesh,Conway Morris Andrew,Barbier François,Timsit Jean-François,Lipman Jeffrey,Litton Edward,Palermo Anna Maria,Yap Timothy,Eroglu Ege,Hosokawa Koji,Yoshida Hideki,Fujitani Shigeki,Zand Farid,Mahmoodpoor Ata,Tabatabaei Seyed Mohammad Nasirodin,Elrabi Omar,Almekhlafi Ghaleb A.,Vidal Gabriela,Aparicio Marta,Alonzo Irene,Namendys-Silva Silvio A.,Hermosillo Mariana,Castillo Roberto Alejandro,De Bus Liesbet,De Waele Jan,Hollevoet Isabelle,De Schryver Nicolas,Serck Nicolas,Kovacevic Pedja,Zlojutro Biljana,Ruppe Etienne,Montravers Philippe,Dulac Thierry,Castanera Jérémy,Massri Alexandre,Guesdon Charlotte,Garcon Pierre,Duprey Matthieu,Philippart François,Tran Marc,Bruel Cédric,Kalfon Pierre,Badre Gaëtan,Demeret Sophie,Le Guennec Loïc,Bassetti Matteo,Giacobbe Daniele,Sales Gabriele,Daroui Ivan,Lodi Giovanni,Ippolito Mariachiara,Bellina Davide,Di Guardo Andrea,Rocco Monica,Fiorelli Silvia,Mikstacki Adam,Peichota Mariusz,Pietraszek-Grzywaczewska Iwona,Póvoa Pedro,Krystopchuk Andriy,Teresa Ana,de Figueiredo António Manuel Pereira,Botelho Isabel,Costa Vasco,Cunha Rui Pedro,Gritsan Alexey,Belskiy Vladislav,Furman Mikhail,Martinez Maria,Casares Vanessa,Arnillas Maria Pilar Gracia,Bermudez Rosana Munoz,Ubeda Alejandro,Salgado Maria,Maseda Emilio,De La Rica Alejandro Suarez,Blasco-Navalpotro Miguel Angel,Gallego Alberto Orejas,Prazak Josef,Pagani J. L.,Abed-Maillard S.,Iskit Arzu Topeli,Mehtap Selcuk,Ceyhun Solakoğlu,Kalem Ayşe Kaya,Kurt Ibrahim,Telli Murat,Ozturk Barcin,Baykam Nurcan,Karaali Ridvan,Koksal Iftihar,Bilir Yeliz,Guzeldag Seda,Ersoz Gulden,Evik Guliz,Bayindir Yasar,Ersoy Yasemin,Ercole Ari,Raj Ashok,Zormpa Artemis,Tinaslanidis George,Khade Reena,Roshdy Ashraf,Kannan Santhana,Antrolikar Supriya,Marsden Nicholas,Attwood Ben,Patel Jamie,Gurjar Mohan,Dsilva Carol,Chandran Jagadish,Sanousi Bashir El,Saidahmed Elfayadh,Hamid Hytham K. S.,
Abstract
Abstract
Background
The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients.
Methods
We used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients’ characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models.
Results
A total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49–2.45).
Conclusions
We showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality.
Trial registration ClinicalTrials.org number NCT03937245. Registered 3 May 2019.
Funder
Swiss National Science Foundation
European society of Intensive Care Medicine
European Society of Clinical Microbiology and Infectious Diseases
Norva Dahlia foundation and the Redcliffe Hospital Private Practice Trust Fund