Frontiers in Public Health (Sep 2023)
Clinical characteristics and prognosis of pneumonia-related bloodstream infections in the intensive care unit: a single-center retrospective study
- Yijie Liu,
- Yijie Liu,
- Yijie Liu,
- Yijie Liu,
- Yijie Liu,
- Yijie Liu,
- Ting Sun,
- Ting Sun,
- Ting Sun,
- Ting Sun,
- Ting Sun,
- Ying Cai,
- Ying Cai,
- Ying Cai,
- Ying Cai,
- Ying Cai,
- Tianshu Zhai,
- Tianshu Zhai,
- Tianshu Zhai,
- Tianshu Zhai,
- Tianshu Zhai,
- Linna Huang,
- Linna Huang,
- Linna Huang,
- Linna Huang,
- Linna Huang,
- Qi Zhang,
- Qi Zhang,
- Qi Zhang,
- Qi Zhang,
- Qi Zhang,
- Chunlei Wang,
- Chunlei Wang,
- Chunlei Wang,
- Chunlei Wang,
- Chunlei Wang,
- He Chen,
- Xu Huang,
- Xu Huang,
- Xu Huang,
- Xu Huang,
- Xu Huang,
- Min Li,
- Min Li,
- Min Li,
- Min Li,
- Min Li,
- Jingen Xia,
- Jingen Xia,
- Jingen Xia,
- Jingen Xia,
- Jingen Xia,
- Sichao Gu,
- Sichao Gu,
- Sichao Gu,
- Sichao Gu,
- Sichao Gu,
- Lingxi Guo,
- Lingxi Guo,
- Lingxi Guo,
- Lingxi Guo,
- Lingxi Guo,
- Bin Yang,
- Xiaojing Wu,
- Xiaojing Wu,
- Xiaojing Wu,
- Xiaojing Wu,
- Xiaojing Wu,
- Xiaojing Wu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu,
- Qingyuan Zhan,
- Qingyuan Zhan,
- Qingyuan Zhan,
- Qingyuan Zhan,
- Qingyuan Zhan,
- Qingyuan Zhan
Affiliations
- Yijie Liu
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Yijie Liu
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Yijie Liu
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Yijie Liu
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Yijie Liu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Yijie Liu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Ting Sun
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Ting Sun
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Ting Sun
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Ting Sun
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Ting Sun
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Ying Cai
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Ying Cai
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Ying Cai
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Ying Cai
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Ying Cai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Tianshu Zhai
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Tianshu Zhai
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Tianshu Zhai
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Tianshu Zhai
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Tianshu Zhai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Linna Huang
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Linna Huang
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Linna Huang
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Linna Huang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Linna Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Qi Zhang
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Qi Zhang
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Qi Zhang
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Qi Zhang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Qi Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Chunlei Wang
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Chunlei Wang
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Chunlei Wang
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Chunlei Wang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Chunlei Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- He Chen
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
- Xu Huang
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Xu Huang
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Xu Huang
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Xu Huang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Xu Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Min Li
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Min Li
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Min Li
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Min Li
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Min Li
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Jingen Xia
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Jingen Xia
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Jingen Xia
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Jingen Xia
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Jingen Xia
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Sichao Gu
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Sichao Gu
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Sichao Gu
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Sichao Gu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Sichao Gu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Lingxi Guo
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Lingxi Guo
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Lingxi Guo
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Lingxi Guo
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Lingxi Guo
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Bin Yang
- Vision Medicals Center for Infection Diseases, Guangzhou, China
- Xiaojing Wu
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Xiaojing Wu
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Xiaojing Wu
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Xiaojing Wu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Xiaojing Wu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Xiaojing Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang University, Jiangxi, China
- Binghuai Lu
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Binghuai Lu
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Binghuai Lu
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Binghuai Lu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Binghuai Lu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Qingyuan Zhan
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Qingyuan Zhan
- National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Qingyuan Zhan
- State Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, China
- Qingyuan Zhan
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Qingyuan Zhan
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- Qingyuan Zhan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- DOI
- https://doi.org/10.3389/fpubh.2023.1249695
- Journal volume & issue
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Vol. 11
Abstract
BackgroundBloodstream infections (BSI) are one of the most severe healthcare-associated infections in intensive care units (ICU). However, there are few studies on pneumonia-related BSI (PRBSI) in the ICU. This study aimed to investigate the clinical and prognostic characteristics of patients with PRBSI in the ICU and to provide a clinical basis for early clinical identification.MethodsWe retrospectively collected data from patients with bacterial BSI in a single-center ICU between January 1, 2017, and August 31, 2020. Clinical diagnosis combined with whole-genome sequencing (WGS) was used to clarify the diagnosis of PRBSI, and patients with PRBSI and non-PRBSI were analyzed for clinical features, prognosis, imaging presentation, and distribution of pathogenic microorganisms.ResultsOf the 2,240 patients admitted to the MICU, 120 with bacterial BSI were included in this study. Thirty-two (26.7%) patients were identified as having PRBSI based on the clinical diagnosis combined with WGS. Compared to patients without PRBSI, those with PRBSI had higher 28-day mortality (81.3 vs.51.1%, p = 0.003), a higher total mortality rate (93.8 vs. 64.8%, p = 0.002), longer duration of invasive mechanical ventilation (median 16 vs. 6 days, p = 0.037), and prolonged duration of ICU stay (median 21 vs. 10 days, p = 0.004). There were no differences in other baseline data between the two groups, but patients with PRBSI had extensive consolidation on chest radiographs and significantly higher Radiographic Assessment of Lung Edema scores (mean 35 vs. 24, p < 0.001). The most common causative organisms isolated in the PRBSI group were gram-negative bacteria (n = 31, 96.9%), with carbapenem-resistant gram-negative bacteria accounting for 68.8% (n = 22) and multidrug-resistant bacteria accounting for 81.3% (n = 26).ConclusionPneumonia-related BSI is an important component of ICU-BSI and has a poor prognosis. Compared to non-PRBSI, patients with PRBSI do not have typical clinical features but have more severe lung consolidation lesions, and should be alerted to the possibility of their occurrence when combined with pulmonary gram-negative bacterial infections, especially carbapenem-resistant bacteria. Further multicenter, large-sample studies are needed to identify the risk factors for the development of PRBSI and prevention and treatment strategies.
Keywords
- bloodstream infections
- pneumonia-related bloodstream infections
- clinical characteristics
- intensive care unit
- gram-negative bacteria