TY - JOUR
T1 - Hospital-Acquired Bloodstream Infections in Relation to Intensive Care Unit Stays During Hospitalization - A Population-Based Cohort Study
AU - Gradel, Kim Oren
AU - Coia, John Eugenio
AU - Chen, Ming
AU - Nielsen, Stig Lønberg
AU - Jensen, Thøger Gorm
AU - Møller, Jens Kjølseth
AU - Dessau, Ram Benny Christian
AU - Póvoa, Pedro
PY - 2024/12/20
Y1 - 2024/12/20
N2 - Background: Little is known about the clinical characteristics and pathogens causing hospital-acquired bloodstream infections (HA-BSIs) in relation to an intensive care unit (ICU) stay. Methods: Population-based cohort study, comprising 35% of the Danish population, 2009–2016. We derived four patient groups with first-time HA-BSIs: no ICU stay during the admission (non-ICU patients) and HA-BSI acquired before, in, or after an ICU stay (before-ICU, in-ICU, and after-ICU patients). These groups were compared in relation to microbiological and clinical characteristics, including 28- and >28-day mortality. Results: Among 6888 HA-BSI patients, 4017, 792, 1388, and 691 were non-ICU, before-ICU, in-ICU, and after-ICU, respectively. The rates of several microorganisms differed between the patient groups, e.g., Enterococci (9.4% of non-ICU and 32.0% of in-ICU patients). The 28-day mortality was 26.3% in non-ICU, 45.0% in before-ICU, 35.6% in in-ICU, and 19.0% in after-ICU patients. The corresponding adjusted hazard ratios (95% confidence interval) were 2.10 (1.85–2.36), 1.67 (1.50–1.87), and 0.76 (0.63–0.91) (reference: non-ICU patients). There were few differences as regards >28-day mortality. Conclusions: We found large differences between common microorganisms and prognosis between the four patient groups. After-ICU patients had the lowest 28-day mortality despite age and comorbidity characteristics similar to the other three groups.
AB - Background: Little is known about the clinical characteristics and pathogens causing hospital-acquired bloodstream infections (HA-BSIs) in relation to an intensive care unit (ICU) stay. Methods: Population-based cohort study, comprising 35% of the Danish population, 2009–2016. We derived four patient groups with first-time HA-BSIs: no ICU stay during the admission (non-ICU patients) and HA-BSI acquired before, in, or after an ICU stay (before-ICU, in-ICU, and after-ICU patients). These groups were compared in relation to microbiological and clinical characteristics, including 28- and >28-day mortality. Results: Among 6888 HA-BSI patients, 4017, 792, 1388, and 691 were non-ICU, before-ICU, in-ICU, and after-ICU, respectively. The rates of several microorganisms differed between the patient groups, e.g., Enterococci (9.4% of non-ICU and 32.0% of in-ICU patients). The 28-day mortality was 26.3% in non-ICU, 45.0% in before-ICU, 35.6% in in-ICU, and 19.0% in after-ICU patients. The corresponding adjusted hazard ratios (95% confidence interval) were 2.10 (1.85–2.36), 1.67 (1.50–1.87), and 0.76 (0.63–0.91) (reference: non-ICU patients). There were few differences as regards >28-day mortality. Conclusions: We found large differences between common microorganisms and prognosis between the four patient groups. After-ICU patients had the lowest 28-day mortality despite age and comorbidity characteristics similar to the other three groups.
U2 - 10.3390/jcm13247783
DO - 10.3390/jcm13247783
M3 - Journal article
C2 - 39768706
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 24
M1 - 7783
ER -