Portal de investigação
Hospital-acquired bloodstream infections in critically ill cirrhotic patients: a post-hoc analysis of the EUROBACT-2 international cohort study
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Wozniak, Hannah
- Tabah, Alexis
- Barbier, Francois
- Ruckly, Stephane
- Loiodice, Ambre
- Akova, Murat
- Leone, Marc
- Morris, Andrew Conway
- Bassetti, Matteo
- Arvaniti, Kostoula
- Ferrer, Ricard
- de Bus, Liesbet
- Bracht, Hendrik
- Mikstacki, Adam
- Alsisi, Adel
- Valeanu, Liana
- Prazak, Josef
- Timsit, Jean-Francois
- Buetti, Niccolo
- UROBACT-2 Study Grp
Unidades de investigação
Abstract
Background Hospital-acquired bloodstream infections are common in the intensive care unit (ICU) and have a high mortality rate. Patients with cirrhosis are especially susceptible to infections, yet there is a knowledge gap in the epidemiological distinctions in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients in the ICU. It has been suggested that cirrhotic patients, present a trend towards more gram-positive infections, and especially enterococcal infections. This study aims to describe epidemiological differences in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients hospitalized in the ICU regarding infection sources, microorganisms and mortality. Methods Using prospective Eurobact-2 international cohort study data, we compared hospital-acquired bloodstream infections sources and microorganisms in cirrhotic and non-cirrhotic patients. The association between Enterococcus faecium and cirrhosis was studied using a multivariable mixed logistic regression. The association between cirrhosis and mortality was assessed by a multivariable frailty Cox model. Results Among the 1059 hospital-acquired bloodstream infections patients included from 101 centers, 160 had cirrhosis. Hospital-acquired bloodstream infection source in cirrhotic patients was primarily abdominal (35.6%), while it was pulmonary (18.9%) for non-cirrhotic (p < 0.01). Gram-positive hospital-acquired bloodstream infections accounted for 42.3% in cirrhotic patients compared to 33.2% in non-cirrhotic patients (p = 0.02). Hospital-acquired bloodstream infections in cirrhotic patients were most frequently caused by Klebsiella spp (16.5%), coagulase-negative Staphylococci (13.7%) and E. faecium (11.5%). E. faecium bacteremia was more frequent in cirrhotic patients (11.5% versus 4.5%, p < 0.01). After adjusting for possible confounding factors, cirrhosis was associated with higher E. faecium hospital-acquired bloodstream infections risk (Odds ratio 2.5, 95% CI 1.3-4.5, p < 0.01). Cirrhotic patients had increased mortality compared to non-cirrhotic patients (Hazard Ratio 1.3, 95% CI 1.01-1.7, p = 0.045). Conclusions Critically ill cirrhotic patients with hospital-acquired bloodstream infections exhibit distinct epidemiology, with more Gram-positive infections and particularly Enterococcus faecium.
Dados da publicação
- ISSN/ISSNe:
- 2110-5820, 2110-5820
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 38698291
- Link para outro recurso:
- www.scopus.com
Annals of Intensive Care Springer-Verlag GmbH and Co. KG
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 1
Documentos
- Não há documentos
Filiações
Keywords
- RISK-FACTORS; OUTCOMES
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Citar a publicação
Wozniak H,Tabah A,Barbier F,Ruckly S,Loiodice A,Akova M,Leone M,Morris AC,Bassetti M,Arvaniti K,Ferrer R,de Bus L,Paiva JA,Bracht H,Mikstacki A,Alsisi A,Valeanu L,Prazak J,Timsit J,Buetti N,UROBACT GRP. Hospital-acquired bloodstream infections in critically ill cirrhotic patients: a post-hoc analysis of the EUROBACT-2 international cohort study. Ann. Intensive Care. 2024. 14. (1):70. IF:8,100. (1).
