Portal de investigação
Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Tabah, A
- Buetti, N
- Staiquly, Q
- Ruckly, S
- Akova, M
- Aslan, AT
- Leone, M
- Morris, AC
- Bassetti, M
- Arvaniti, K
- Lipman, J
- Ferrer, R
- Qiu, H
- Povoa, P
- De Bus, L
- De Waele, J
- Zand, F
- Gurjar, M
- Alsisi, A
- Abidi, K
- Bracht, H
- Hayashi, Y
- Jeon, K
- Elhadi, M
- Barbier, F
- Timsit, JF
- EUROBACT-2 Study Grp
- ESICM
- ESCMID ESGCIP
- OUTCOMEREA Network
Unidades de investigação
Abstract
PurposeIn the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials.MethodsWe carried out a prospective international cohort study of adult patients (>= 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021.Results2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28.ConclusionsHA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
Dados da publicação
- ISSN/ISSNe:
- 1432-1238, 0342-4642
- Tipo:
- Article
- Páginas:
- 178-190
- Link para outro recurso:
- www.scopus.com
Intensive Care Medicine Springer Verlag
Citações Recebidas na Web of Science: 49
Citações Recebidas na Scopus: 98
Documentos
- Não há documentos
Filiações
Keywords
- bloodstream infection; bacteremia; hospital-acquired; antibiotic resistance
Financiamento
Proyectos asociados
The impact of the Covid-19 pandemic on antimicrobial consumption: a descriptive and correlation analysis in a tertiary care hospital in Portugal
Investigador Principal: José Artur Osório de Carvalho Paiva
Estudo Clínico Académico (Antimicrobial consumpti) . 2021
Severe community-acquired pneumonia: from severity assessment to outcome.
Investigador Principal: José Artur Osório de Carvalho Paiva
Estudo Clínico Académico . 2022
Citar a publicação
Tabah A,Buetti N,Staiquly Q,Ruckly S,Akova M,Aslan AT,Leone M,Morris AC,Bassetti M,Arvaniti K,Lipman J,Ferrer R,Qiu H,Paiva JA,Povoa P,De Bus L,De Waele J,Zand F,Gurjar M,Alsisi A,Abidi K,Bracht H,Hayashi Y,Jeon K,Elhadi M,Barbier F,Timsit JF,EUROBACT GRP,E,ESCMID E,OUTCOMEREA N. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med. 2023. 49. (2):p. 178-190. IF:38,900. (1).
