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Bloodstream infections in the COVID-19 era: results from an Italian multi-centre study

Zeno Pasquini1, Iacopo Barocci2, Lucia Brescini2

  • 1Università Politecnica delle Marche Facoltà di Medicina e Chirurgia, Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Macerata, Italy; Azienda Ospedaliera Ospedali Riuniti Marche Nord, Malattie Infettive, Pesaro, Italy.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|August 20, 2021
PubMed

Insights

Bloodstream infections (BSIs) are common in patients with coronavirus disease 2019 (COVID-19), occurring more frequently and with higher mortality. These infections, often caused by resistant bacteria, pose a significant risk during hospitalization.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Critical Care Medicine

Background:

  • The impact of the COVID-19 pandemic on secondary infections like bloodstream infections (BSIs) requires thorough investigation.
  • Previous studies have explored the correlation between COVID-19 and superinfections, but a comprehensive assessment is still needed.

Purpose of the Study:

  • To evaluate the incidence and characteristics of bloodstream infections (BSIs) in patients with COVID-19.
  • To compare BSI rates and outcomes in COVID-19 patients versus non-COVID-19 patients during the pandemic.
  • To analyze the timing of BSI onset and associated mortality in hospitalized patients.

Main Methods:

  • A multi-centre study was conducted across four Italian hospitals.
  • Data from patients admitted between January 1 and June 30, 2020, were analyzed.
  • Clinical, demographic, and microbiological data were compared with data from the same period in 2019 and with non-COVID-19 patients admitted in 2020.

Main Results:

  • Patients with COVID-19 had a significantly higher incidence of BSIs (8.19 episodes/1000 patient-days) compared to non-COVID-19 patients (2.72/1000 patient-days) and the 2019 cohort (2.76/1000 patient-days).
  • BSI onset was delayed in COVID-19 patients (16 days) versus non-COVID-19 patients (5 days).
  • Thirty-day mortality was substantially higher in COVID-19 patients with BSIs (40.2%) compared to those without (23.7%).
  • Multi-drug-resistant pathogens frequently caused BSIs in COVID-19 patients, with variations between centers.

Conclusions:

  • Bloodstream infections are a significant secondary complication in COVID-19 patients.
  • Hospitalized COVID-19 patients face an elevated risk of developing BSIs.
  • BSIs in this population are associated with a high mortality rate, underscoring the need for vigilant management.
Abstract

Keywords:
COVID-19Hospital acquired infectionMulti drug resistantSARS-CoV-2 pandemicbloodstream infections

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