• Niccolò Buetti, Alexis Tabah, Ambre Loiodice, Stéphane Ruckly, Abdullah Tarik Aslan, Giorgia Montrucchio, Andrea Cortegiani, Nese Saltoglu, Bircan Kayaaslan, Firdevs Aksoy, Akova Murat, Özlem Akdoğan, Kemal Tolga Saracoglu, Cem Erdogan, Marc Leone, Ricard Ferrer, José-Artur Paiva, Yoshiro Hayashi, Mahesh Ramanan, Conway MorrisAndrewADivision of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.Division of Immunology, Department of Pathology, University of Cambridge, Cambridge, UK.JVF Intensive Care Unit, Addenbrooke's Hospital, Cambridge,, François Barbier, Jean-François Timsit, and Eurobact 2 study group.
• Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland. niccolo.buetti@gmail.com.
• Crit Care. 2022 Oct 18; 26 (1): 319319.

BackgroundThe study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients.MethodsWe used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients' characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models.ResultsA total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49-2.45).ConclusionsWe showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality. Trial registration ClinicalTrials.org number NCT03937245 . Registered 3 May 2019.© 2022. The Author(s).

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