Patterns, Outcomes and Economic Burden of Primary vs. Secondary Bloodstream Infections: A Single Center,...

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Health Economics

Background:

• Bloodstream infections (BSIs) present significant morbidity and mortality, categorized as primary (unidentified source) or secondary (localized origin).
• Understanding differences in patterns, outcomes, and costs between primary and secondary BSIs is crucial for effective management.

Purpose of the Study:

• To compare the clinical patterns, patient outcomes, and associated medical costs of primary versus secondary bloodstream infections.
• To identify factors associated with primary and secondary BSIs.

Main Methods:

• A single-center retrospective cohort study of 201 patients with confirmed BSIs at the University Hospital of Patras, Greece (May 2016-May 2018).
• Analysis of patient demographics, clinical data, severity scores (SOFA, APACHE II, SAPS, qPitt), hospitalization duration, mortality rates, and total care costs.

Main Results:

• Primary BSIs constituted 22.89% of cases and were associated with younger patients, predominantly nosocomial acquisition, and higher clinical severity scores.
• Primary BSI patients experienced longer hospital stays (21 vs. 12 days) and significantly higher total care costs (EUR 4388.3 vs. EUR 2530.25).
• Mortality rates were higher in primary BSI (43.24% vs. 26.09%), though not statistically significant.

Conclusions:

• Primary BSIs present distinct clinical and economic challenges compared to secondary BSIs, necessitating prompt diagnosis and targeted antimicrobial strategies.
• The findings highlight the need for specific management guidelines for primary BSIs and interventions to mitigate the overall burden of bloodstream infections.