Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: a descriptive analysis of the Eurobact II study.
Bacteremia
Bloodstream infection
COVID-19
Enterococcus
ICU-acquired
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
18 10 2022
18 10 2022
Historique:
received:
15
07
2022
accepted:
12
09
2022
entrez:
18
10
2022
pubmed:
19
10
2022
medline:
21
10
2022
Statut:
epublish
Résumé
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. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 36258239
doi: 10.1186/s13054-022-04166-y
pii: 10.1186/s13054-022-04166-y
pmc: PMC9578203
doi:
Banques de données
ClinicalTrials.gov
['NCT03937245']
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
319Subventions
Organisme : Swiss National Science Foundation
ID : P4P4PM_194449
Pays : Switzerland
Investigateurs
Jeffrey Lipman
(J)
Edward Litton
(E)
Anna Maria Palermo
(AM)
Timothy Yap
(T)
Ege Eroglu
(E)
Koji Hosokawa
(K)
Hideki Yoshida
(H)
Shigeki Fujitani
(S)
Farid Zand
(F)
Ata Mahmoodpoor
(A)
Seyed Mohammad Nasirodin Tabatabaei
(SMN)
Omar Elrabi
(O)
Ghaleb A Almekhlafi
(GA)
Gabriela Vidal
(G)
Marta Aparicio
(M)
Irene Alonzo
(I)
Silvio A Namendys-Silva
(SA)
Mariana Hermosillo
(M)
Roberto Alejandro Castillo
(RA)
Liesbet De Bus
(L)
Jan De Waele
(J)
Isabelle Hollevoet
(I)
Nicolas De Schryver
(N)
Nicolas Serck
(N)
Pedja Kovacevic
(P)
Biljana Zlojutro
(B)
Etienne Ruppe
(E)
Philippe Montravers
(P)
Thierry Dulac
(T)
Jérémy Castanera
(J)
Alexandre Massri
(A)
Charlotte Guesdon
(C)
Pierre Garcon
(P)
Matthieu Duprey
(M)
François Philippart
(F)
Marc Tran
(M)
Cédric Bruel
(C)
Pierre Kalfon
(P)
Gaëtan Badre
(G)
Sophie Demeret
(S)
Loïc Le Guennec
(L)
Matteo Bassetti
(M)
Daniele Giacobbe
(D)
Gabriele Sales
(G)
Ivan Daroui
(I)
Giovanni Lodi
(G)
Mariachiara Ippolito
(M)
Davide Bellina
(D)
Andrea Di Guardo
(A)
Monica Rocco
(M)
Silvia Fiorelli
(S)
Adam Mikstacki
(A)
Mariusz Peichota
(M)
Iwona Pietraszek-Grzywaczewska
(I)
Pedro Póvoa
(P)
Andriy Krystopchuk
(A)
Ana Teresa
(A)
António Manuel Pereira de Figueiredo
(AMP)
Isabel Botelho
(I)
Vasco Costa
(V)
Rui Pedro Cunha
(RP)
Alexey Gritsan
(A)
Vladislav Belskiy
(V)
Mikhail Furman
(M)
Maria Martinez
(M)
Vanessa Casares
(V)
Maria Pilar Gracia Arnillas
(MPG)
Rosana Munoz Bermudez
(RM)
Alejandro Ubeda
(A)
Maria Salgado
(M)
Emilio Maseda
(E)
Alejandro Suarez De La Rica
(AS)
Miguel Angel Blasco-Navalpotro
(MA)
Alberto Orejas Gallego
(AO)
Josef Prazak
(J)
J L Pagani
(JL)
S Abed-Maillard
(S)
Arzu Topeli Iskit
(AT)
Selcuk Mehtap
(S)
Solakoğlu Ceyhun
(S)
Ayşe Kaya Kalem
(AK)
Ibrahim Kurt
(I)
Murat Telli
(M)
Barcin Ozturk
(B)
Nurcan Baykam
(N)
Ridvan Karaali
(R)
Iftihar Koksal
(I)
Yeliz Bilir
(Y)
Seda Guzeldag
(S)
Gulden Ersoz
(G)
Guliz Evik
(G)
Yasar Bayindir
(Y)
Yasemin Ersoy
(Y)
Ari Ercole
(A)
Ashok Raj
(A)
Artemis Zormpa
(A)
George Tinaslanidis
(G)
Reena Khade
(R)
Ashraf Roshdy
(A)
Santhana Kannan
(S)
Supriya Antrolikar
(S)
Nicholas Marsden
(N)
Ben Attwood
(B)
Jamie Patel
(J)
Mohan Gurjar
(M)
Carol Dsilva
(C)
Jagadish Chandran
(J)
Bashir El Sanousi
(BE)
Elfayadh Saidahmed
(E)
Hytham K S Hamid
(HKS)
Informations de copyright
© 2022. The Author(s).
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