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Differences between COVID-19 and non-COVID-19 patients' bloodstream infections: a single-center retrospective study
Çağla Keskin Sarıtaş1, Halit Özsüt2, Aysun Benli2
1Department of Infectious Diseases and Clinical Microbiology, Marmara University Training and Research Hospital, Istanbul, Turkey.
Insights
COVID-19 patients with intensive care unit (ICU)-associated bloodstream infections (BSIs) showed higher rates of multidrug-resistant (MDR) bacteria, linked to prior antibiotic use. These patients experienced shorter survival times post-BSI compared to non-COVID-19 patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Intensive care unit (ICU)-acquired bloodstream infections (BSIs) pose a significant threat to patient outcomes.
- Understanding the specific characteristics of BSIs in coronavirus disease 2019 (COVID-19) patients is crucial for effective management.
Purpose of the Study:
- To compare epidemiological, clinical, microbiological, and outcome data of COVID-19 and non-COVID-19 patients with ICU-acquired BSIs.
- To identify risk factors associated with mortality in BSI patients.
Main Methods:
- A retrospective study of 234 patients with ICU-acquired BSIs between March 2020 and April 2022.
- Patients were categorized into COVID-19 (n=127) and non-COVID-19 (n=107) groups.
- Descriptive statistics and logistic regression analysis were employed to compare groups and identify mortality risk factors.
Main Results:
- COVID-19 patients had a higher incidence of respiratory sources for BSIs (43.3% vs. 26%).
- Acinetobacter baumannii and Gram-negative multidrug-resistant (MDR) bacteria were significantly more prevalent in COVID-19 patients (24.4% vs. 5.6% and 81.7% vs. 61.7%, respectively).
- Longer prior antibiotic use in COVID-19 patients was associated with MDR Gram-negative bacterial BSIs, and COVID-19 patients had shorter survival times post-BSI.
Conclusions:
- Multidrug-resistant microorganisms are prevalent in COVID-19 patients with ICU-acquired BSIs.
- Prior antibiotic use in hospitals contributes to the development of MDR bacterial BSIs in COVID-19 patients.
- COVID-19 is associated with poorer outcomes in patients with ICU-acquired BSIs.
Introduction:
This study aimed to examine the differences between coronavirus disease 2019 (COVID-19) and non-COVID-19 patients with intensive care unit (ICU)-associated bloodstream infections (BSIs), in terms of epidemiological, clinical, microbiological, and outcome data.
Methodology:
All patients who were followed up in the ICU of a university hospital between 18 March 2020 and 18 April 2022, and who had developed ICU-acquired BSI, based on the study criteria, were selected and divided into 2 groups: COVID-19 and non-COVID-19. Descriptive statistics were used to analyze differences between the groups. Logistic regression analysis was applied to determine mortality risk factors in BSI patients.
Results:
234 patients were treated for ICU-acquired BSI, 127 COVID-19 and 107 non-COVID-19. Respiratory sources were significantly more common in COVID-19 patients compared to non-COVID-19 patients (43.3% vs. 26%, p = < 0.01). Among the causative pathogens, Acinetobacter baumannii (24.4% vs. 5.6%, p ≤ 0.01) and Gram-negative multidrug-resistant (MDR) bacteria (81.7% vs. 61.7%, p = 0.020) were detected more frequently in COVID-19 patients than in non-COVID-19 patients. The duration of antibiotic use in the hospital before BSI was longer in COVID-19 patients than in non-COVID-19 patients, and this was also associated with BSI in which Gram-negative MDR bacteria were active (p = < 0.01). Survival times after BSI were shorter in COVID-19 patients than in non-COVID-19 patients (p = 0.032).
Conclusions:
We demonstrated that MDR microorganisms were prevalent in COVID-19 patients with ICU-acquired BSI, and this was partly due to antibiotic use in the hospital prior to BSI.
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