Published in:
Open Access
01-12-2022 | COVID-19 | Research
Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: a descriptive analysis of the Eurobact II study
Authors:
Niccolò Buetti, Alexis Tabah, Ambre Loiodice, Stéphane Ruckly, Abdullah Tarik Aslan, Giorgia Montrucchio, Andrea Cortegiani, Nese Saltoglu, Bircan Kayaaslan, Firdevs Aksoy, Akova Murat, Özlem Akdoğan, Kemal Tolga Saracoglu, Cem Erdogan, Marc Leone, Ricard Ferrer, José-Artur Paiva, Yoshiro Hayashi, Mahesh Ramanan, Andrew Conway Morris, François Barbier, Jean-François Timsit, the Eurobact 2 study group
Published in:
Critical Care
|
Issue 1/2022
Login to get access
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.