Infectious Diseases Unit IRCCS, Policlinico Sant'Orsola, Department Medical Surgical Science, University of Bologna, Bologna, Italy.
Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.
Infection. 2023 Feb;51(1):129-136. doi: 10.1007/s15010-022-01853-4. Epub 2022 Jun 10.
This multicenter observational study was done to evaluate risk factors related to the development of BSI in patients admitted to ICU for COVID-19.
All patients with COVID-19 admitted in two COVID-19 dedicated ICUs in two different hospital between 02-2020 and 02-2021 were recruited.
537 patients were included of whom 265 (49.3%) experienced at least one BSI. Patients who developed bacteremia had a higher SOFA score [10 (8-12) vs 9 (7-10), p < 0.001], had been intubated more frequently [95.8% vs 75%, p < 0.001] and for a median longer time [16 days (9-25) vs 8 days (5-14), p < 0.001]. Patients with BSI had a median longer ICU stay [18 days (12-31.5) vs 9 days (5-15), p < 0.001] and higher mortality [54% vs 42.3%, p < 0.001] than those who did not develop it. Development of BSI resulted in a higher SOFA score [aHR 1.08 (95% CI 1.03-1.12)] and a higher Charlson score [csAHR 1.15 (95% CI 1.05-1.25)].
A high SOFA score and a high Charlson score resulted associated with BSI's development. Conversely, immunosuppressive therapy like steroids and tocilizumab, has no role in increasing the risk of bacteremia.
本多中心观察性研究旨在评估与 COVID-19 患者入住 ICU 期间发生血流感染(BSI)相关的危险因素。
招募了 2020 年 2 月至 2021 年 2 月期间在两家不同医院的两家 COVID-19 专用 ICU 住院的所有 COVID-19 患者。
共纳入 537 例患者,其中 265 例(49.3%)至少发生过一次 BSI。发生菌血症的患者 SOFA 评分更高[10(8-12)比 9(7-10),p<0.001],气管插管的频率更高[95.8%比 75%,p<0.001],插管时间中位数更长[16 天(9-25)比 8 天(5-14),p<0.001]。发生 BSI 的患者 ICU 住院时间中位数更长[18 天(12-31.5)比 9 天(5-15),p<0.001],死亡率更高[54%比 42.3%,p<0.001]。与未发生 BSI 的患者相比。BSI 的发生导致 SOFA 评分更高(aHR 1.08[95%CI 1.03-1.12])和 Charlson 评分更高(csAHR 1.15[95%CI 1.05-1.25])。
高 SOFA 评分和高 Charlson 评分与 BSI 的发生相关。相反,皮质类固醇和托珠单抗等免疫抑制治疗与增加菌血症风险无关。