Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Oct 18;26(1):319.
doi: 10.1186/s13054-022-04166-y.

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  1   2 , Alexis Tabah  3   4   5 , Ambre Loiodice  6 , Stéphane Ruckly  6 , Abdullah Tarik Aslan  7 , Giorgia Montrucchio  8   9 , Andrea Cortegiani  10   11 , Nese Saltoglu  12 , Bircan Kayaaslan  13 , Firdevs Aksoy  14 , Akova Murat  15 , Özlem Akdoğan  16 , Kemal Tolga Saracoglu  17 , Cem Erdogan  18 , Marc Leone  19 , Ricard Ferrer  20 , José-Artur Paiva  21   22 , Yoshiro Hayashi  23 , Mahesh Ramanan  24   25   26 , Andrew Conway Morris  27   28   29 , François Barbier  30   31 , Jean-François Timsit  32   33 ; Eurobact 2 study group
Collaborators, Affiliations
Observational Study

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 et al. Crit Care. .

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.

Keywords: Bacteremia; Bloodstream infection; COVID-19; Enterococcus; ICU-acquired.

PubMed Disclaimer

Conflict of interest statement

The authors have disclosed that they do not have conflict of interest. Dr. Buetti received a grant from the Swiss National Science Foundation (Grant Number: P4P4PM_194449). Prof. Timsit received fees for lectures to 3M, MSD, Pfizer, and BioMérieux; he received research grants from Astellas, 3M, MSD, and Pfizer; and he participated to advisory boards of 3M, MSD, Bayer Pharma, Nabriva, and Pfizer. Dr. Barbier received consulting and lecture fees from MSD and BioMérieux. Prof. Cortegiani received fees for lectures from Gilead, MSD, Pfizer; and he participated to advisory boards of MSD, Gilead, Pfizer. Dr. Montrucchio received fees for lectures from Gilead, Pfizer, Thermofisher; and she participated to advisory boards of Gilead. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Prof. Akova received grants from Pfizer and Gilead, had lecture fees paid to the institution by Pfizer and Sanofi. Dr. Ramanan acknowledges support from the Metro North Hospital and Health Services Clinician-Researcher Fellowship. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Dr. Conway Morris is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1). Prof. José-Artur Paiva received fees for consulting, advisory boards or lectures from MSD, Pfizer, Astra-Zeneca, Gilead, Jansen, Cepheid, AOP Orphan Pharmaceuticals.

Figures

Fig. 1
Fig. 1
Flowchart
Fig. 2
Fig. 2
Distribution of microorganisms between COVID-19 and non-COVID-19 patients in all HABSI and in ICU-acquired HABSI. HA-BSI hospital-acquired bloodstream infection, ICU intensive care unit, spp. species
Fig. 3
Fig. 3
Survival curves for all, ICU-acquired, enterococcal and DTR Gram-negative HABSI. ICU intensive care unit, HA-BSI hospital-acquired bloodstream infection, DTR difficult to treat resistance, Vs versus
See this image and copyright information in PMC

References

    1. Tabah A, Koulenti D, Laupland K, Misset B, Valles J, Bruzzi de Carvalho F, et al. Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: the EUROBACT International Cohort Study. Intensive Care Med. 2012;38(12):1930–1945. doi: 10.1007/s00134-012-2695-9. - DOI - PubMed
    1. Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, et al. Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA. 2020;323(15):1478–1487. doi: 10.1001/jama.2020.2717. - DOI - PMC - PubMed
    1. Buetti N, Ruckly S, de Montmollin E, Reignier J, Terzi N, Cohen Y, et al. COVID-19 increased the risk of ICU-acquired bloodstream infections: a case-cohort study from the multicentric OUTCOMEREA network. Intensive Care Med. 2021;47(2):180–187. doi: 10.1007/s00134-021-06346-w. - DOI - PMC - PubMed
    1. Langford BJ, So M, Leung V, Raybardhan S, Lo J, Kan T, et al. Predictors and microbiology of respiratory and bloodstream bacterial infection in patients with COVID-19: living rapid review update and meta-regression. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2022;28(4):491–501. - PMC - PubMed
    1. Ippolito M, Simone B, Filisina C, Catalanotto FR, Catalisano G, Marino C, et al. Bloodstream infections in hospitalized patients with COVID-19: a systematic review and meta-analysis. Microorganisms. 2021;9(10):2016. doi: 10.3390/microorganisms9102016. - DOI - PMC - PubMed

Publication types

Associated data