Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients’ Outcome
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Protocol
2.2. Definitions
2.3. Microbiology
2.4. Statistical Analysis
3. Results
3.1. Microbial Epidemiology
3.2. Antimicrobial Resistance
3.3. Case-Control Analysis for Clinical Data and Outcome
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Non-COVID-19 Departments 1 | COVID-19 Department 1 | ||||
---|---|---|---|---|---|
Pathogens | n | % | n | % | p |
Acinetobacter baumannii complex | 35 | 8.16% | 8 | 14.3% | 0.135 |
Anaerobes | 9 | 2.10% | |||
Candida sp. | 38 | 8.86% | 11 | 19.64% | 0.018 |
Enterobacter cloacae complex | 5 | 1.17% | |||
Enterococcus spp. | 59 2 | 13.75% | 21 3 | 37.5% | <0.001 |
Escherichia coli | 69 | 16.08% | 4 | 7.1% | 0.109 |
Klebsiella sp. (other than pneumoniae) | 6 | 1.40% | |||
Klebsiella pneumoniae | 55 | 12.82% | 3 | 5.4% | 0.126 |
Other Gram-negatives | 21 | 4.90% | 1 | 1.8% | |
Other Gram-positives | 4 | 0.93% | |||
Proteus mirabilis | 18 | 4.20% | 1 | 1.8% | 0.711 |
Pseudomonas aeruginosa | 32 | 7.46% | 1 | 1.8% | 0.157 |
Serratia marcescens | 5 | 1.17% | |||
Staphylococcus aureus | 56 | 13.05% | 4 | 7.1% | 0.280 |
Stenotrophomonas maltophilia | 7 | 1.63% | 1 | 1.8% | >0.999 |
Streptococcus sp. | 10 | 2.33% | 1 | 1.8% | >0.999 |
Total | 429 | 56 4 |
Variables | Total, n = 80 | BSI Group n = 40 | Non-BSI Group n = 40 | p |
---|---|---|---|---|
Male n (%) | 38 (47.5) | 19 (47.5) | 19 (47.5) | >0.999 |
Female n (%) | 42 (52.5) | 21 (52.5) | 21 (52.5) | |
Age, mean (±SD) | 71.14 (14.28) | 71.20 (14.25) | 71.08 (14.48) | 0.923 |
Prior hospitalization n (%) | 15 (18.8) | 13 (32.5) | 2 (5) | 0.003 |
Vaccination for COVID-19 n (%) | 14 (17.5) | 1 (2.5) | 13 (32.5) | 0.001 |
Comorbidities | ||||
Heart disease n (%) | 28(35) | 20 (50) | 8 (20) | 0.009 |
Hypertention n (%) | 47 (58.8) | 26 (65) | 21 (52.5) | 0.364 |
Stroke n (%) | 8 (10) | 6 (15) | 2 (5) | 0.263 |
Peripheral vascular disease n (%) | 16 (20) | 15 (37.5) | 1 (2.5) | <0.001 |
Diabetes mellitus | 28 (35) | 17 (42.5) | 11 (27.5) | 0.241 |
Dyslipidemia n (%) | 34 (42.5) | 23 (57.5) | 11 (27.5) | 0.012 |
Respiratory disease n (%) | 15 (18.8) | 12 (30) | 3 (7.5) | 0.020 |
Chronic kidney disease n (%) | 10 (12.5) | 5 (12.5) | 5 (12.5) | >0.999 |
Neurological disease n (%) | 15 (18.8) | 12 (30) | 3 (7.5) | 0.020 |
Psychiatric conditions n (%) | 13 (16.5) | 13 (32.5) | 0 | <0.001 |
Malignancy n (%) | 9 (11.3) | 6 (15) | 3 (7.5) | 0.481 |
Autoimmune diseases | 10 (12.5) | 7 (17.5) | 3 (7.5) | 0.311 |
More than 2 comorbidities | 41 (51.2) | 31 (77.5) | 10 (25) | <0.001 |
Severe SARS-CoV2 pneumonia n (%) | 47 (58.8) | 33 (82.5) | 14 (35) | <0.001 |
Central venous catheter n (%) | 25 (31.3) | 18 (45) | 7 (17.5) | 0.015 |
Length of hospital stay mean (±SD) | 14.68 (9.66) | 19.92 (9.56) | 9.57(6.58) | 0.001 |
Need for mechanical invasive ventilation–ICU transfer n (%) | 17 (21.3) | 16 (40) | 1 (2.5) | <0.001 |
Variables | Discharge Home n = 54 (67.5%) | Adverse Outcome n = 26 (32.5%) | Univariate OR (CI 95%) | p | Multivariate Adjusted OR (CI 95%) | p |
---|---|---|---|---|---|---|
Age > 60 years | 42 (77.8) | 22 (84.6) | 1.571 (0.453–5.450 | 0.562 | 1.345 (0.276–6.564) | 0.714 |
Male Female | 24 (44.4) 30 (55.6) | 14 (53.8) 12 (46.2) | 1458 (0.570–3.731) | 0.480 | ||
Vaccination for COVID-19 | 14 (28.9) | 0 (0) | 0.606 (0.499–0.736) | 0.003 | ||
Prior hospitalization-transfer from hospital/nursing care | 7 (13) | 8 (30.8) | 2.984 (0.941–9.431) | 0.071 | ||
Comorbidities | ||||||
History of Stroke | 3 (5.6) | 5 (19.2) | 4.048 (0.886–18.486) | 0.105 | ||
Heart Disease | 16 (29.6) | 12 (46.2) | 2.036 (0.774–5.356) | 0.211 | ||
Arterial hypertension | 30 (55.6) | 17 (65.4) | 1.511 (0.573–3.986) | 0.472 | ||
Dyslipidemia | 20 (37) | 14 (53.8) | 1.983 (0.768–5.120) | 0.227 | ||
Respiratory disease | 11 (20.4) | 4 (15.4) | 0.711 (0.203–2.492) | 0.763 | ||
Diabetes mellitus | 17 (31.5) | 11 (42.3) | 1.596 (0.607–4.198) | 0.453 | ||
Malignancy | 5 (9.3) | 4 (15.4) | 1.782 (0.436–7.282) | 0.462 | ||
Renal failure | 6 (11.1) | 4 (15.4) | 1.455 (0.373–5.679) | 0.720 | ||
Peripheral vascular disease | 8 (14.8) | 8 (30.8) | 2.556 (0.833–7.843) | 0.135 | ||
Autoimmune diseases | 6 (11.1) | 4 (15.4) | 1.455 (0.373–5.679) | 0.720 | ||
Psychiatric disorders | 3 (5.6) | 10 (38.5) | 10.625 (2.601–43/395) | <0.001 | 2.325 (0.476–11.369) | 0.297 |
Neurological disorders | 4 (7.4) | 11 (42.3) | 9.167 (2.545–33.022) | <0.001 | 5.704 (1.103–29.495) | 0.038 |
Bacteremia | 16 (29.6) | 24 (92.3) | 28.500 (6.011–135.121) | <0.001 | 19.512 (3.672–103.668) | <0.001 |
Severe SARS-CoV-2 pneumonia | 21 (38.9) | 26 (100) | 2.238 (1.628–3.076) | <0.001 |
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Giannitsioti, E.; Louka, C.; Mamali, V.; Kousouli, E.; Velentza, L.; Papadouli, V.; Loizos, G.; Mavroudis, P.; Kranidiotis, G.; Rekleiti, N.; et al. Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients’ Outcome. Microorganisms 2022, 10, 1314. https://doi.org/10.3390/microorganisms10071314
Giannitsioti E, Louka C, Mamali V, Kousouli E, Velentza L, Papadouli V, Loizos G, Mavroudis P, Kranidiotis G, Rekleiti N, et al. Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients’ Outcome. Microorganisms. 2022; 10(7):1314. https://doi.org/10.3390/microorganisms10071314
Chicago/Turabian StyleGiannitsioti, Efthymia, Christina Louka, Vasiliki Mamali, Elisavet Kousouli, Lemonia Velentza, Vaia Papadouli, Georgios Loizos, Panagiotis Mavroudis, Georgios Kranidiotis, Nektaria Rekleiti, and et al. 2022. "Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients’ Outcome" Microorganisms 10, no. 7: 1314. https://doi.org/10.3390/microorganisms10071314