Hospital-Acquired Bloodstream Infections in Relation to Intensive Care Unit Stays During Hospitalization-A...

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Epidemiology

Background:

• Hospital-acquired bloodstream infections (HA-BSIs) are a significant concern in healthcare settings.
• Limited understanding exists regarding the specific clinical features and causative pathogens of HA-BSIs in relation to intensive care unit (ICU) stays.

Purpose of the Study:

• To investigate the clinical characteristics and microbiological profiles of HA-BSIs.
• To compare outcomes, including mortality, among patients with HA-BSIs based on their ICU stay status.

Main Methods:

• A population-based cohort study was conducted using Danish national data from 2009-2016.
• Patients with first-time HA-BSIs were categorized into four groups: non-ICU, before-ICU, in-ICU, and after-ICU.
• Microbiological data, clinical characteristics, and mortality (28-day and >28-day) were analyzed.

Main Results:

• Among 6888 HA-BSI patients, significant differences in microorganism prevalence were observed between groups (e.g., Enterococci higher in in-ICU patients).
• 28-day mortality varied significantly: 26.3% (non-ICU), 45.0% (before-ICU), 35.6% (in-ICU), and 19.0% (after-ICU).
• After-ICU patients exhibited the lowest 28-day mortality, despite comparable age and comorbidity profiles.

Conclusions:

• Distinct differences in microbial patterns and patient prognosis exist among HA-BSI groups defined by ICU stay.
• The timing of HA-BSI acquisition relative to ICU care is a critical factor influencing patient outcomes.