Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: a descriptive analysis of the Eurobact II study
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
Affiliations
Niccolò Buetti
Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine
Alexis Tabah
Intensive Care Unit, Redcliffe Hospital, Metro North Hospital and Health Services
Ambre Loiodice
ICURESEARCH
Stéphane Ruckly
ICURESEARCH
Abdullah Tarik Aslan
Department of Internal Medicine, Hacettepe University
Giorgia Montrucchio
Department of Surgical Sciences, University of Turin
Andrea Cortegiani
Department of Surgical Oncological and Oral Science (Di.Chir.On.S.), University of Palermo
Nese Saltoglu
Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa
Bircan Kayaaslan
Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University
Firdevs Aksoy
Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University
Akova Murat
Department of Infectious Diseases and Clinical Microbiology, Hacettepe University
Özlem Akdoğan
Department of Infectious Diseases and Clinical Microbiology, Erol Olçok Research and Training Hospital, Hitit University
Kemal Tolga Saracoglu
Department of Anesthesiology and Reanimation, Kartal Dr. Lütfi Kırdar City Hospital
Cem Erdogan
Department of Anesthesiology and Reanimation, Medipol Mega Hospital
Marc Leone
Department of Anesthesiology and Intensive Care Unit, Hospital Nord, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille University
Ricard Ferrer
Intensive Care Department. SODIR Research Group, Vall d’Hebron Institute of Research VHIR, Hospital Universitari Vall d’Hebron
José-Artur Paiva
Intensive Care Medicine Department, Centro Hospitalar Universitário São João (CHUSJ)
Yoshiro Hayashi
Department of Intensive Care Medicine, Kameda General Hospital
Mahesh Ramanan
Caboolture and The Prince Charles Hospitals, Metro North Hospital and Health Services
Andrew Conway Morris
Division of Anaesthesia, Department of Medicine, University of Cambridge
François Barbier
Médecine Intensive Réanimation, Centre Hospitalier Régional d’Orléans
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.
