1. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study
- Author
-
Rashidi, Mahboobeh, Hamid, Hytham K S, Saidahmed, Elfayadh, Karar, Ali Adil Ali, Mc Cree, Melanie, Adeola, Fowotade, Idowu, Olusola, Oladimeji, Motunrayo, Asiyanbi, Gabriel, Desalu, Ibironke, Olatosi, John O, Ugwu, Euphemia Mgbosoro, Yakubu, Saidu Yusuf, Misra, Krushna Chandra, Sheshala, Kaladhar, Mukherjee, Sudipta, Ghosh, Pralay, Chandran, Jagadish, Dsilva, Carol, Baby, Sailaja K, Renuka, M K, Patel, Mayur, Rathod, Darshana, Datta, Avijatri, Bose, Payel, Siddiqui, Suhail Sarwar, Ozair, Ahmad, Muzaffar, Syed Nabeel, Shekhar, Saurav, Singh, Ritu, Pahuja, Madhumati, Jain, Nikhilesh, Rubina, Noor Ahmedi, Vaidyanathan, R, Samdani, Pratit, Nimbolkar, Janardan, Sharma, Priya, Karmakar, Saurabh, Sharma, Ankur, Kothari, Nikhil, Baronia, Arvind, Gurjar, Mohan, Islam, Mohammad Motiul, Hasan, Rajib, Huq, Shihan Mahmud Redwanul, Rabbani, Raihan, Hewer, Tayne, Thompson, Patricia, Sligl, Wendy, Kutsogiannis, Demetrios J, McCoshen, Lorena, Baig, Nadia, Burma, Yaroslava, Sokhan, Anton, Renaud, Paul Jean, Humphreys, Miss Sally K, Tilley, Rebecca E, Patel, Jamie, Attwood, Ben, Chikungwa, Moses, Jackson, Matthew, Zaki, Ahmed, Banach, Dorota, Torre, Valentina Della, Marsden, Nicholas, Antrolikar, Supriya, Kannan, Santhana, Mckee, Rachel, Mcguigan, Peter, Baikady, R Rao, Jhanji, S, Black, E, Husain, A, Loftus, S, Tatham, Kate, Hall, Daniel, Longbottom, Rebecca, Baumer, Tom, Szakmany, Tamas, Roshdy, Ashraf, Sanderson, Amanda, Ritzema, Jenny, Keegan, Allison, Cerman, Jaroslav, Graham, Clive, Smith, Tim, Cole, Stephen, Cobb, Katherine, Parcell, Benjamin J, Angell, Hollie, Hugill, Keith, Franke, Uwe, Arias, Sonia Sousa, Templeton, Maie, Lennard, James, Macfie, Caroline, Johnson, Aimee, Dolan, Rachael, Yonan, Aimee, Soltan, Marina, Bajaj, Manan, Goyal, Shraddha, Mulhi, Randeep, Torlinski, Tomasz, Khade, Reena, Tinaslanidis, George, Zormpa, Artemis, Raj, Ashok, Kent, Melanie, Cowton, Amanda, Faulkner, Maria, Tizard, Kate, Rojo, Roceld, Antcliffe, David, Ercole, Ari, Morris, Andrew Conway, Routledge, Matthew, Aktas, Sabahat Cagan, Batirel, Ayse, Akyol, Ahmet, Goksu, Senay, Ersoy, Yasemin, Bayindir, Yasar, Altin, Nilgün, Gürbüz, Yunus, Erdoğan, Cem, Ozgen, Cansu, Sungurtekin, Hulya, Evik, Guliz, Ersoz, Gulden, Guzeldag, Seda, Bilir, Yeliz, Saracoglu, Kemal Tolga, Eroglu, Ahmet, Aksoy, Firdevs, Koksal, Iftihar, Karaali, Ridvan, Saltoglu, Nese, Cakmak, Rumeysa, Tunay, Burcu, Yilmaz, Mesut, Akdogan, Ozlem O, Baykam, Nurcan N, Çolak, Onur, Agalar, Canan, Sari, Ali, Gundogan, KÜRŞAT, Akbas, Türkay, Çolak, Sait, Demiray, Emine Kubra Dindar, Erol, Çiğdem, Ozturk, Barcin, Telli, Murat, Kurt, Ibrahim, Kalem, Ayşe Kaya, Kayaaslan, Bircan, Talan, Leyla, Altintas, Neriman Defne, Ceyhun, Solakoğlu, Mehtap, Selcuk, Kusoglu, Hulya, Kocagoz, Sesin, Timuroglu, Arif, Aslan, Abdullah Tarik, Akova, Murat, Abed-Maillard, S, Pagani, Jl, Jakob, Stephan, Prazak, Josef, De Geer, Lina, Åkerlund, Joyce, Edin, Alicia, Haney, Michael, Svensson, Carl Johan, Spahic, Dzana, Sjövall, Fredrik, Gallego, Alberto Orejas, Blasco-Navalpotro, Miguel Angel, Novo, Mariana, Ayestaran, J Ignacio, De La Rica, Alejandro Suarez, Maseda, Emilio, Rodriguez, Dra M, Asensio, Dra Mj, Prieto, Emilio Garcia, Espina, Lorena Forcelledo, Salgado, Dra Maria, Ubeda, Alejandro, Gomà, Gemma, Santos, Emilio Diaz, Quesada, María Dolores, Raguer, Laura, Roig, Regina, Catalan, Beatriz, Armestar, Fernando, Bermudez, Rosana Munoz, Arnillas, Maria Pilar Gracia, Amerigo, Joaquin Amador, Flores, Matias, Vera, Paula, Casares, Vanessa, Martinez, Maria, Rocca, Ricard Ferrer, Furman, Mikhail, Belskiy, Vladislav, Chukina, Maria, Vistovskaya, Natala, Eremenko, Aleksandr, Gaigolnik, Denis, Tribulev, Maksim, Zubareva, Nadezhda, Magomedov, Marat, Meleshkina, Yulia, Anderzhanova, Anastasia, Gritsan, Alexey, Lungu, Olguta, Grigoras, Ioana, Marcu, Alexandra, Popescu, Mihai, Tomescu, Dana, Predoi, Cornelia Elena, Filipescu, Daniela Carmen, Cobilinschi, Cristian, Grintescu, Ioana Marina, Bubenek-Turconi, Serban, Valeanu, Liana, Mendes, António Carvalho, Pereira, Énio, Moura, José Pedro, Nunes, Cristina, Pascoalinho, Dulce, Queiró, Joana, Ledo, Sara, da Costa, Tito, Molinos, Elena, Cunha, Rui Pedro, Costa, Vasco, Duarte, Tiago, Botelho, Isabel, de Figueiredo, António Manuel Pereira, Teresa, Ana, Krystopchuk, Andriy, Pinto, Ana Rios, Marques, Ana Josefina Pinheiro, Alves, Madalena, Guimarães, Nádia, Pereira, Tiago, Cartoze, Nuno, Bisanti, Alessandra, Martin-Loeches, Ignacio, Pietraszek-Grzywaczewska, Iwona, Peichota, Mariusz, Broda, Hanna, Nowakowski, Tomasz, Wasowska, Dominika, Walczak-Wieteska, Paulina, Kotkowska, Anna, Bojko, Jozef, Szczesniak, Anna, Komorowska, Irmina Kaptur, Tamowicz, Barbara, Mikstacki, Adam, Rizzo, Anna Chiara, Cotoia, Antonella, Fiorelli, Silvia, Rocco, Monica, Covotta, Marco, Pelagalli, Lorella, Di Guardo, Andrea, Bellina, Davide, Ippolito, Mariachiara, Cortegiani, Andrea, Battaglini, Denise, Pelosi, Paolo, Schlevenin, Maria Grazia, Zuccaro, Francesco, Lodi, Giovanni, Daroui, Ivan, Mirabella, Michele, Porcile, Elisa, Gratarola, Angelo, Giacobbe, Daniele Roberto, Di Gravio, Valentina, Vargas, Joel, Carelli, Simone, Montini, Luca Maria, De Pascale, Gennaro, Sales, Gabriele, Montrucchio, Giorgia, Papathanakos, Georgios, Kouroulas, Vasilios, Retselas, Ioannis, Theodorou, Vasiliki, Marouli, Diamantina, Malliotakis, Polychronis, Almiroudi, Mariota Panagiota, Dimopoulos, Georges, Ali, Fadi, Papageorgiou, Eirini, Athanasa, Zoi, Sakagianni, Aikaterini, Chantziara, Vasiliki, Efthymiou, Anna, Georgopoulou, Maria, Chatzis, Marinos, Sakkalis, Anastasios, Nikolaou, Charikleia, Kogkopoulos, Evangelos, Oikonomou, Marina, Kampolis, C, Papanikolaou, M, Marmanidou, Kyriaki, Paskalis, Harry, Karaiskos, Ilias, Moldovan, Leora, Matei, Mariana Kristina, Koutsoukou, Vasiliki, Romanou, Vasiliki, Vasileiou, Maria, Renta, Foteini, Papoti, Sofia, Iasonidou, Cristina, Kaimakamis, Evangelos, Soulountsi, Vasiliki, Fildisis, Georgios, Psallida, Vasiliki, Smyrniotis, Dimitrios, Arvaniti, Kostoula, Temirov, Talgat, Merenkov, Yevgeniy, Babashev, Baurzhan, Kaligozhin, Zhannur, Bazhykayeva, Yelena, Mugazov, Miras, Ymbetzhanov, Yerlan, Viderman, Dmitriy, Metz, Carlos, Lepper, Philippe, Wempe, Carola, Gottschalk, Antje, Schmidt, Karsten, Dubler, Simon, Pasieka, Bastian, Petros, Sirak, Thomas-Rueddel, Daniel, Bloos, Frank, Hoheisen, Sandra, Bracht, Hendrik, Klouche, Kada, Imzi, Nadia, Dahyot-Fizelier, Claire, Fartoukh, Muriel, Voiriot, Guillaume, Aparicio, Christelle, Siami, Shidasp, Le Guennec, Loïc, Demeret, Sophie, Silva, Stein, Sarton, Benjamine, Roger, Claire, Lefrant, Jean-Yves, Larcher, Romaric, Badre, Gaëtan, Kalfon, Pierre, Razazi, Keyvan, Dessap, Armand Mekonted, Baudry, Thomas, Argaud, Laurent, Smonig, Roland, Louis, Guillaume, Bourenne, Jérémy, Gainnier, Marc, Barbier, François, Djanikian, Flora, Perrigault, Pierre-François, Foucrier, Arnaud, Janny, Sylvie, Weiss, Emmanuel, Bruel, Cédric, Tran, Marc, Philippart, François, Paulet, Rémi, Thyrault, Martial, Duprey, Matthieu, Garcon, Pierre, Mira, Jean-Paul, Le Souhaitier, Mathieu, Bortolotti, Perrine, Kipnis, Eric, Duburcq, Thibault, Coupez, Elisabeth, Souweine, Bertrand, Nica, Alexandru, Alfandari, Serge, Leroy, Olivier, Rosman, Jérémy, Mateu, Philippe, Escudier, Etienne, Guesdon, Charlotte, Massri, Alexandre, Beuzelin, M, Marchalot, A, Le Meur, Anthony, Auchabie, Johann, Castanera, Jérémy, Dulac, Thierry, Montravers, P, Zappela, N, Patrier, Juliette, Timsit, Jean-François, Arbelot, Charlotte, Leone, Marc, Lasic, Hrvoje, Nikolic, Mario, Sakan, Sanja, Persec, Jasminka, Brajkovic, Ana Vujaklija, Radonic, Radovan, Filipovic-Grcic, Ina, Custovic, Aida, Zlojutro, Biljana, Kovacevic, Pedja, Opdenacker, Godelive, De Waele, Elisabeth, Wittebole, Xavier, Serck, Nicolas, De Schryver, Nicolas, Misset, Benoît, Layos, Nathalie, Noel, Cindérella, Biston, Patrick, Haentjens, Lionel, Henin, Pierre, Mesland, Jean-Baptiste, Vanderhaeghen, Sofie F M, Bourgeois, Marc, Denys, Wouter, Hollevoet, Isabelle, De Waele, Jan, De Bus, Liesbet, Tomas, Ernesto Deloya, Perez-Nieto, Orlando R, Tejeda-Huezo, Brigitte, Sánchez-Hurtado, Luis, Ñamendys-Silva, Silvio A, Davalos-Alvarez, Adrian, Dominguez-Cherit, Jose G, Lomeli-Teran, Manuel, Villafuerte, Missael Vladimir Espinoza, Herrera, Mara Ocotlan Gonzalez, Aguilar, Candy Garcia, Leal, Jesús Nicolás Pantoja, Castillo, Roberto Alejandro, Hermosillo, Mariana, Romero-Gonzalez, Juan P, Reyes, Luis Felipe, Montefiore, Pablo, Nuccetelli, Yanina, Alonzo, Microbiologa Irene, Aparicio, Dra Marta, Segura, Matías, Fernández, Rubén, Lopez, Patricia Mabel, Acevedo, José Oscar, Morvillo, Lic Natalia, Centeno, Pablo, Sellami, Walid, Turki, Olfa, Bouaziz, Mounir, Bakr, Lubna, Al-Jadaan, Mohammad, Abu-Sayf, Natalia, Chaaban, Mohammad Karam, Aljabbary, Ahmed, Awad, Maher, Almekhlafi, Ghaleb A, Elrabi, Omar, Sallam, Hend, Nissar, Shaikh, Lance, Marcus, Karic, Edin, Elbuzidi, Abdurahaman, Hssain, Ali Ait, Jayyab, Mustafa Abu, Amro, Sarah, Belkhadir, Z, Ghannam, A, Hachimi, Abdelhamid, Younes, Oujidi, Housni, Brahim, Zeggwagh, Amine Ali, Dendane, Tarek, Wajdi, Maazouzi Ahmed, Mouhssine, Doumiri, Kanjaa, Nabil, Boukatta, Brahim, Seddiki, Rachid, Serghini, Issam, Hasan, Rabab Shaban Ben, Hasan, Hayat Ben, Jobran, Rania, Hdada, Aisha Khaled, Abousnina, Fathi A, Abdulwahed, Eman, Taher, Ahmed Sa, Bouhuwaish, Ahmad, Bilkhayr, Hala, Almiqlash, Bushray, Homaidan, Ahmed Gaber Sadik, AliAli, Almajdoub Mohammed, Aqeelah, Ahmed, Gamra, Marwa, Buimsaedah, Ahmad, Fares, Aya, Ibrahim, Rebecca, Abilama, Fayez, Diab, Adei, Harara, Belal, Levin, Phillip, Belman, Daniel, Rigler, Merav, Kagan, Ilya, Singer, Pierre, Ahmed, Abdullah Khudhur, Tabatabaei, Seyed Mohammad Nasirodin, Tajvidi, Ramin, Masjedi, Mansoor, Sarshad, Hakimeh, Sabetian, Golnar, Dabiri, Gholamreza, Aalinezhad, Fatemeh, Mahmoodpoor, Ata, Zargar, Mohammad Amin, Kiani, Arash, Amiri, Fereshteh, Javaherforoosh, Fatemeh, Baghbanian, Reza, Soltani, Farhad, Savaie, Mohsen, Ahmadi, Fatemeh, Kashipazha, Davood, Mehraban, Zahra, Borsi, Seyed Hamid, Ouhadian, Maryam, Zand, Farid, Hemead, Hanan M, Awad, Ahmed K, Elbadawy, Merihan A, Elsayed, Ahmed, Elmandouh, Omar, Aldhalia, Amer, Saber, Ahmed, Elbahnasawy, Mohamed, Mostafa, Tarek, Osman, Nermin, Barsoum, Mina, Elhadidy, Amr, Alsisi, Adel, Houfi, Ashraf El, Nadeem, Rashid, Chiewroongroj, Supattra, Apichatbutr, Yutthana, Wongsurakiat, Phunsup, Ku, Shih-Chi, Kuo, Li-Kuo, Hu, Ting-Yu, Cia, Cong-Tat, Chou, Nai-Kuan, Yeh, Yu Chang, Ng, Louis Xiang Long, Ng, Kangqi, Quah, Jessica Lishan, Lim, Jia Yan, Ong, Caroline Yu Ming, Li, Andrew Yunkai, Goh, Ken Junyang, Kwa, Andrea Lay Hoon, Lie, Sui An, Ng, Shin Yi, Goh, Qing Yuan, Lim, Sung Yoon, Park, Seung Yong, Park, Sunghoon, Lee, Sang-Min, Jeon, Kyeongman, Ali, Saedah, Mazlan, Mohd Zulfakar, Azman, Abd Hamid, Tong, Lee Kok, Noor, Zuraini Md, Rahman, Hamizah Bt Abdul, Fong, Kean Khang, Wong, Siong Ling Danny, Liew, Mun Thing, Visvalingam, Sheshendrasurian, Pheng, Lee See, Jamaluddin, Muhamad Fadhil Hadi, Hasan, M Shahnaz, Takaki, Shunsuke, Kato, Hideaki, Atobe, Kaori, Saito, Hiroki, Rinka, Hiroshi, Omori, Koichiro, Fujitani, Shigeki, Yoshida, Hideki, Nagashima, Michio, Mishima, Yuka, Shigemitsu, Hidenobu, Kuriyama, Akira, Matsuyoshi, Takeo, Makino, Jun, Hosokawa, Koji, Hashimoto, Satoru, Yamasaki, Masaki, Karumai, Toshiyuki, Hayashi, Yoshiro, Geng, Nan, Peije, Li, Weifeng, Xie, Ye, Ling, Qin, Bingyu, Wang, Yan, Yan, Jing, Huang, Min, Zhou, Suming, Hu, Chungfang, Ye, Jilu, Zhang, Min, Yin, Yongjie, Wang, Jinfeng, Wang, Ruilan, Yin, Chengfen, Xu, Lei, Mingmin, Chen, Wusi, Qiu, Zhao, Juan, Zhao, Peng, Wang, Hao, Chen, Xiaomei, Luo, Jili, Qian, Chuanyun, Zhen, Wang, Wei-Hua, Lu, Jianfeng, Xie, Haibo, Qiu, Sridharan, Dhadappa Damodar, Sudhirchandra, Shah, Moorthi, P Dhakshina, Mon, Tomas, Walid, Haji Adi Muhamad Ibnu, Tabah, Alexis, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Conway Morris, Andrew, Bassetti, Matteo, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, Abidi, Khalid, Elhadi, Muhammed, Pollock, Hamish, Margetts, Ben, Young, Meredith, Bhadange, Neeraj, Tyler, Steven, Ledtischke, Anne, Finnis, Mackenzie, Dwivedi, Jyotsna, Saxena, Manoj, Biradar, Vishwanath, Soar, Natalie, Sarode, Vineet, Brewster, David, Regli, Adrian, Weeda, Elizabeth, Ahmed, Samiul, Fourie, Cheryl, Laupland, Kevin, Ramanan, Mahesh, Walsham, James, Meyer, Jason, Litton, Edward, Palermo, Anna Maria, Yap, Timothy, Eroglu, Ege, Attokaran, Antony George, Jaramillo, C'havala, Nafees, Khalid Mahmood Khan, Rashid, Nurhikmahtul Aqilah Haji Abd, Tabah, Alexi, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Akova, Murat, Aslan, Abdullah Tarik, Leone, Marc, Conway Morris, Andrew, Bassetti, Matteo, Arvaniti, Kostoula, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, De Bus, Liesbet, De Waele, Jan, Zand, Farid, Gurjar, Mohan, Alsisi, Adel, Abidi, Khalid, Bracht, Hendrik, Hayashi, Yoshiro, Jeon, Kyeongman, Elhadi, Muhammed, Barbier, Françoi, Timsit, Jean-Françoi, EUROBACT-2 Study Group, ESICM, ESCMID ESGCIP and the OUTCOMEREA Network including, Andrea Cortegiani, and Mariachiara Ippolito
- Subjects
antibiotic resistance ,bloodstream infection ,hospital-acquired ,bacteremia ,Critical Care and Intensive Care Medicine - Abstract
Purpose: In 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. Methods: We carried out a prospective international cohort study of adult patients (≥ 18years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 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) waspresent in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24h 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 alivefrom hospital by day-28. Conclusions: HA-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.
- Published
- 2023