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Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study

With the aim of describing the burden and epidemiology of community-acquired/healthcare-associated and hospital-acquired bloodstream infections (CA/HCA-BSIs and HA-BSIs) in patients hospitalised with COVID-19, and evaluating the risk factors for BSIs and their relative impact on mortality, an observ...

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Autores principales: Cona, Andrea, Tavelli, Alessandro, Renzelli, Andrea, Varisco, Benedetta, Bai, Francesca, Tesoro, Daniele, Za, Alessandro, Biassoni, Caterina, Battaglioli, Lodovica, Allegrini, Marina, Viganò, Ottavia, Gazzola, Lidia, Bini, Teresa, Marchetti, Giulia Carla, d’Arminio Monforte, Antonella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470708/
https://www.ncbi.nlm.nih.gov/pubmed/34572613
http://dx.doi.org/10.3390/antibiotics10091031
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author Cona, Andrea
Tavelli, Alessandro
Renzelli, Andrea
Varisco, Benedetta
Bai, Francesca
Tesoro, Daniele
Za, Alessandro
Biassoni, Caterina
Battaglioli, Lodovica
Allegrini, Marina
Viganò, Ottavia
Gazzola, Lidia
Bini, Teresa
Marchetti, Giulia Carla
d’Arminio Monforte, Antonella
author_facet Cona, Andrea
Tavelli, Alessandro
Renzelli, Andrea
Varisco, Benedetta
Bai, Francesca
Tesoro, Daniele
Za, Alessandro
Biassoni, Caterina
Battaglioli, Lodovica
Allegrini, Marina
Viganò, Ottavia
Gazzola, Lidia
Bini, Teresa
Marchetti, Giulia Carla
d’Arminio Monforte, Antonella
author_sort Cona, Andrea
collection PubMed
description With the aim of describing the burden and epidemiology of community-acquired/healthcare-associated and hospital-acquired bloodstream infections (CA/HCA-BSIs and HA-BSIs) in patients hospitalised with COVID-19, and evaluating the risk factors for BSIs and their relative impact on mortality, an observational cohort study was performed on patients hospitalised with COVID-19 at San Paolo Hospital in Milan, Italy from 24 February to 30 November 2020. Among 1351 consecutive patients hospitalised with COVID-19, 18 (1.3%) had CA/HCA-BSI and 51 (3.8%) HA-BSI for a total of 82 episodes of BSI. The overall incidence of HA-BSI was 3.3/1000 patient-days (95% CI 2.4–4.2). Patients with HA-BSI had a longer hospital stay compared to CA/HCA-BSI and no-BSI groups (27 (IQR 21–35) vs. 12 (7–29) vs. 9 (5–17) median-days, p < 0.001) but a similar in-hospital mortality (31% vs. 33% vs. 25%, p = 0.421). BSI was not associated with an increased risk of mortality (CA/HCA-BSI vs. non-BSI aOR 1.27 95% CI 0.41–3.90, p = 0.681; HA-BSI vs. non-BSI aOR 1.29 95% CI 0.65–2.54, p = 0.463). Upon multivariate analysis, NIMV/CPAP (aOR 2.09, 95% CI 1.06–4.12, p = 0.034), IMV (aOR 5.13, 95% CI 2.08–12.65, p < 0.001) and corticosteroid treatment (aOR 2.11, 95% CI 1.06–4.19, p = 0.032) were confirmed as independent factors associated with HA-BSI. Development of HA-BSI did not significantly affect mortality. Patients treated with corticosteroid therapy had double the risk of developing BSI.
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spelling pubmed-84707082021-09-27 Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study Cona, Andrea Tavelli, Alessandro Renzelli, Andrea Varisco, Benedetta Bai, Francesca Tesoro, Daniele Za, Alessandro Biassoni, Caterina Battaglioli, Lodovica Allegrini, Marina Viganò, Ottavia Gazzola, Lidia Bini, Teresa Marchetti, Giulia Carla d’Arminio Monforte, Antonella Antibiotics (Basel) Article With the aim of describing the burden and epidemiology of community-acquired/healthcare-associated and hospital-acquired bloodstream infections (CA/HCA-BSIs and HA-BSIs) in patients hospitalised with COVID-19, and evaluating the risk factors for BSIs and their relative impact on mortality, an observational cohort study was performed on patients hospitalised with COVID-19 at San Paolo Hospital in Milan, Italy from 24 February to 30 November 2020. Among 1351 consecutive patients hospitalised with COVID-19, 18 (1.3%) had CA/HCA-BSI and 51 (3.8%) HA-BSI for a total of 82 episodes of BSI. The overall incidence of HA-BSI was 3.3/1000 patient-days (95% CI 2.4–4.2). Patients with HA-BSI had a longer hospital stay compared to CA/HCA-BSI and no-BSI groups (27 (IQR 21–35) vs. 12 (7–29) vs. 9 (5–17) median-days, p < 0.001) but a similar in-hospital mortality (31% vs. 33% vs. 25%, p = 0.421). BSI was not associated with an increased risk of mortality (CA/HCA-BSI vs. non-BSI aOR 1.27 95% CI 0.41–3.90, p = 0.681; HA-BSI vs. non-BSI aOR 1.29 95% CI 0.65–2.54, p = 0.463). Upon multivariate analysis, NIMV/CPAP (aOR 2.09, 95% CI 1.06–4.12, p = 0.034), IMV (aOR 5.13, 95% CI 2.08–12.65, p < 0.001) and corticosteroid treatment (aOR 2.11, 95% CI 1.06–4.19, p = 0.032) were confirmed as independent factors associated with HA-BSI. Development of HA-BSI did not significantly affect mortality. Patients treated with corticosteroid therapy had double the risk of developing BSI. MDPI 2021-08-24 /pmc/articles/PMC8470708/ /pubmed/34572613 http://dx.doi.org/10.3390/antibiotics10091031 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cona, Andrea
Tavelli, Alessandro
Renzelli, Andrea
Varisco, Benedetta
Bai, Francesca
Tesoro, Daniele
Za, Alessandro
Biassoni, Caterina
Battaglioli, Lodovica
Allegrini, Marina
Viganò, Ottavia
Gazzola, Lidia
Bini, Teresa
Marchetti, Giulia Carla
d’Arminio Monforte, Antonella
Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title_full Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title_fullStr Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title_full_unstemmed Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title_short Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study
title_sort incidence, risk factors and impact on clinical outcomes of bloodstream infections in patients hospitalised with covid-19: a prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470708/
https://www.ncbi.nlm.nih.gov/pubmed/34572613
http://dx.doi.org/10.3390/antibiotics10091031
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