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Volume 14
Issue 11
10.3390/pathogens14111152
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Article

MDR Bacteremia in the Critically Ill During COVID-19: The MARTINI Study

by
Karolina Akinosoglou
1,2,3,*,
Christina Petropoulou
1,2,
Vasiliki Karioti
4,
Sotiria Kefala
1,5,
Dimitrios Bousis
5,
Vasiliki Stamouli
6,
Fevronia Kolonitsiou
1,6,
George Dimopoulos
7,
Charalambos Gogos
1 and
Foteini Fligou
1,5
1
Department of Medicine, University of Patras, 26504 Patras, Greece
2
Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Greece
3
Division of Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece
4
Department of Tourism Management, University of Patras, 26504 Patras, Greece
5
Intensive Care Unit, University General Hospital of Patras, 26504 Patras, Greece
6
Department of Microbiology, University General Hospital of Patras, 26504 Patras, Greece
7
3rd Department of Critical Care, Evgenidio Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
*
Author to whom correspondence should be addressed.
Pathogens 2025, 14(11), 1152; https://doi.org/10.3390/pathogens14111152 (registering DOI)
Submission received: 22 September 2025 / Revised: 2 November 2025 / Accepted: 8 November 2025 / Published: 12 November 2025
(This article belongs to the Special Issue Recent Research on Bloodstream Infections)
Versions Notes

Abstract

Multidrug-resistant (MDR) bloodstream infections (BSIs) constitute a major challenge in intensive care units, with the COVID-19 pandemic compromising infection control and potentially increasing MDR incidence. Comparative data between COVID and non-COVID ICU populations remain limited. The MARTINI study is a retrospective observational analysis held in a tertiary hospital during the COVID-19 pandemic (2020–2022) encompassing adult patients with MDR BSIs admitted to COVID and non-COVID ICUs. Demographics, comorbidities, severity scores, microbiology, resistance patterns, and outcomes were accessed and compared. A binary logistic regression model and multivariate regression was performed to identify independent predictors of ICU mortality. Among the study’s 156 patients (106 COVID-ICU, 50 non-COVID-ICU), COVID-ICU patients were significantly older with higher comorbidity and severity scores. Gram-negative pathogens predominated in both cohorts, mainly Acinetobacter baumannii and Klebsiella pneumoniae, with comparable resistance mechanisms. Timing of bacteremia onset and initiation of appropriate therapy did not differ between groups. However, ICU mortality was markedly higher in COVID-ICU patients (74.5% vs. 38%, p < 0.001). Age, SOFA score, the presence of systemic inflammation (SIRS) and COVID-19 infection were identified as independent predictors of mortality. Although pathogen distribution and resistance were similar across groups, COVID-ICU patients experienced significantly poorer outcomes. Strengthened infection control and timely and targeted antimicrobial therapy are essential to diminish MDR bacteremia risk in critically ill populations.
Keywords: multidrug resistant pathogens; antimicrobial resistance; COVID-ICU; critically ill; non-COVID ICU; SARS-CoV-2 multidrug resistant pathogens; antimicrobial resistance; COVID-ICU; critically ill; non-COVID ICU; SARS-CoV-2

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MDPI and ACS Style

Akinosoglou, K.; Petropoulou, C.; Karioti, V.; Kefala, S.; Bousis, D.; Stamouli, V.; Kolonitsiou, F.; Dimopoulos, G.; Gogos, C.; Fligou, F. MDR Bacteremia in the Critically Ill During COVID-19: The MARTINI Study. Pathogens 2025, 14, 1152. https://doi.org/10.3390/pathogens14111152

AMA Style

Akinosoglou K, Petropoulou C, Karioti V, Kefala S, Bousis D, Stamouli V, Kolonitsiou F, Dimopoulos G, Gogos C, Fligou F. MDR Bacteremia in the Critically Ill During COVID-19: The MARTINI Study. Pathogens. 2025; 14(11):1152. https://doi.org/10.3390/pathogens14111152

Chicago/Turabian Style

Akinosoglou, Karolina, Christina Petropoulou, Vasiliki Karioti, Sotiria Kefala, Dimitrios Bousis, Vasiliki Stamouli, Fevronia Kolonitsiou, George Dimopoulos, Charalambos Gogos, and Foteini Fligou. 2025. "MDR Bacteremia in the Critically Ill During COVID-19: The MARTINI Study" Pathogens 14, no. 11: 1152. https://doi.org/10.3390/pathogens14111152

APA Style

Akinosoglou, K., Petropoulou, C., Karioti, V., Kefala, S., Bousis, D., Stamouli, V., Kolonitsiou, F., Dimopoulos, G., Gogos, C., & Fligou, F. (2025). MDR Bacteremia in the Critically Ill During COVID-19: The MARTINI Study. Pathogens, 14(11), 1152. https://doi.org/10.3390/pathogens14111152

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