Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
INSERM, IAME, Université Paris-Cité, 75006, Paris, France.
Crit Care. 2022 Oct 18;26(1):319. doi: 10.1186/s13054-022-04166-y.
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.
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.
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).
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.
本研究旨在描述 COVID-19 和非 COVID-19 危重症患者医院获得性血流感染（HABSIs）的流行病学和结局。
我们使用了 Eurobact II 研究的数据，这是一项关于 ICU 治疗 HABSI 的前瞻性观察性多中心队列研究。对于当前的分析，我们选择了同时包含 COVID-19 和非 COVID-19 危重症患者的中心。我们根据患者特征、感染源和微生物分布，在 COVID-19 和非 COVID-19 之间进行了描述性统计。我们使用多变量脆弱性 Cox 模型研究了 COVID-19 状态与死亡率之间的关联。
来自五大洲 19 个国家的 53 个中心符合入选标准。共有 829 名患者（中位年龄 65 岁[IQR 55；74]；男性，n=538[64.9%]）因 HABSI 接受治疗。纳入的患者包括 252 名 COVID-19 患者和 577 名非 COVID-19 患者。两组患者从住院到 HABSI 的时间间隔相似。COVID-19 患者的呼吸道来源（40.1%比 26.0%，p<0.0001）和原发性 HABSI（25.4%比 17.2%，p=0.006）更为常见。COVID-19 患者的肠球菌（20.5%比 9%）和不动杆菌属（18.8%比 13.6%）HABSI 更为常见。菌血症性 COVID-19 患者的死亡率危险比（HR）高于非 COVID-19 患者（HR 1.91，95%CI 1.49-2.45）。
我们表明，COVID-19 和非 COVID-19 患者的 HABSI 流行病学不同。COVID-19 患者以肠球菌 HABSI 为主。发生 HABSI 的 COVID-19 患者死亡率风险增加。
试验注册ClinicalTrials.org 编号 NCT03937245。注册于 2019 年 5 月 3 日。
