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Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients' Outcome.
Giannitsioti, Efthymia; Louka, Christina; Mamali, Vasiliki; Kousouli, Elisavet; Velentza, Lemonia; Papadouli, Vaia; Loizos, Georgios; Mavroudis, Panagiotis; Kranidiotis, Georgios; Rekleiti, Nektaria; Stamati, Alexandra; Speggos, Ioannis; Daniil, Ioannis; Kouvatsos, Panagiotis; Sidiropoulou, Chrysanthi; Linardaki, Garifallia; Gerakari, Styliani; Chrysos, Georgios; Themeli-Digalaki, Katina; Zarkotou, Olympia.
  • Giannitsioti E; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Louka C; Fourth Department of Internal Medicine, NKUA, ATTIKON University General Hospital, 12462 Athens, Greece.
  • Mamali V; Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Kousouli E; Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Velentza L; Infection Control Action Team, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Papadouli V; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Loizos G; Emergency Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Mavroudis P; Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Kranidiotis G; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Rekleiti N; Second Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Stamati A; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Speggos I; Second Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Daniil I; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Kouvatsos P; Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Sidiropoulou C; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Linardaki G; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Gerakari S; Second Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Chrysos G; Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Themeli-Digalaki K; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
  • Zarkotou O; COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece.
Microorganisms ; 10(7)2022 Jun 29.
Article in English | MEDLINE | ID: covidwho-1917626
ABSTRACT

BACKGROUND:

Bloodstream infections (BSI) caused by highly resistant pathogens in non-ICU COVID-19 departments pose important challenges.

METHODS:

We performed a comparative analysis of incidence and microbial epidemiology of BSI in COVID-19 vs. non-COVID-19, non-ICU departments between 1 September 2020-31 October 2021. Risk factors for BSI and its impact on outcome were evaluated by a case-control study which included COVID-19 patients with/without BSI.

RESULTS:

Forty out of 1985 COVID-19 patients developed BSI. The mean monthly incidence/100 admissions was 2.015 in COVID-19 and 1.742 in non-COVID-19 departments. Enterococcus and Candida isolates predominated in the COVID-19 group (p < 0.001 and p = 0.018, respectively). All Acinetobacter baumannii isolates were carbapenem-resistant (CR). In the COVID-19 group, 33.3% of Klebsiella pneumoniae was CR, 50% of Escherichia coli produced ESBL and 19% of Enterococcus spp. were VRE vs. 74.5%, 26.1% and 8.8% in the non-COVID-19 group, respectively. BSI was associated with prior hospitalization (p = 0.003), >2 comorbidities (p < 0.001), central venous catheter (p = 0.015), severe SARS-CoV-2 pneumonia and lack of COVID-19 vaccination (p < 0.001). In the multivariate regression model also including age and multiple comorbidities, only BSI was significantly associated with adverse in-hospital outcome [OR (CI95%) 21.47 (3.86-119.21), p < 0.001].

CONCLUSIONS:

BSI complicates unvaccinated patients with severe SARS-CoV-2 pneumonia and increases mortality. BSI pathogens and resistance profiles differ among COVID-19/non-COVID-19 departments, suggesting various routes of pathogen acquisition.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study / Risk factors / Screening study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Microorganisms10071314

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study / Risk factors / Screening study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Microorganisms10071314