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Article

Patterns, Outcomes and Economic Burden of Primary vs. Secondary Bloodstream Infections: A Single Center, Cross-Sectional Study

by
Ioannis Chandroulis
1,
Georgios Schinas
2,
Anne-Lise de Lastic
2,
Eleni Polyzou
2,3,
Stamatia Tsoupra
2,3,
Christos Davoulos
3,
Martha Kolosaka
4,
Vasiliki Niarou
5,
Spyridoula Theodoraki
6,
Dimitrios Ziazias
7,
Foteini Kosmopoulou
2,
Christina-Panagiota Koutsouri
8,
Charalambos Gogos
2,9,* and
Karolina Akinosoglou
2,3,10
1
School of Social Sciences, Hellenic Open University, 263 35 Patras, Greece
2
School of Medicine, University of Patras, 265 04 Rio, Greece
3
Department of Internal Medicine, University General Hospital of Patras, 265 04 Rio, Greece
4
Independent Researcher, 272 00 Amaliada, Greece
5
Department of Emergency Care, University General Hospital of Patras, 265 04 Rio, Greece
6
Department of Internal Medicine, General Hospital of Agrinion, 301 31 Agrinio, Greece
7
Department of Internal Medicine, General Hospital of Nikaia-Pireaus “Agios Panteleimon”, 184 54 Nikaia, Greece
8
Department of Internal Medicine, General Hospital of Patras “Agios Andreas”, 263 32 Patra, Greece
9
Department of Internal Medicine and Infectious Diseases, Metropolitan General Hospital, 155 62 Athens, Greece
10
Division of Infectious Diseases, University General Hospital of Patras, 265 04 Rio, Greece
*
Author to whom correspondence should be addressed.
Pathogens 2024, 13(8), 677; https://doi.org/10.3390/pathogens13080677 (registering DOI)
Submission received: 30 June 2024 / Revised: 5 August 2024 / Accepted: 8 August 2024 / Published: 9 August 2024
(This article belongs to the Special Issue Hospital-Acquired Infections and Multidrug-Resistant (MDR) Pathogens)

Abstract

Bloodstream infections (BSIs) can be primary or secondary, with significant associated morbidity and mortality. Primary bloodstream infections (BSIs) are defined as infections where no clear infection source is identified, while secondary BSIs originate from a localized infection site. This study aims to compare patterns, outcomes, and medical costs between primary and secondary BSIs and identify associated factors. Conducted at the University Hospital of Patras, Greece, from May 2016 to May 2018, this single-center retrospective cohort study included 201 patients with confirmed BSIs based on positive blood cultures. Data on patient characteristics, clinical outcomes, hospitalization costs, and laboratory parameters were analyzed using appropriate statistical methods. Primary BSIs occurred in 22.89% (46 patients), while secondary BSIs occurred in 77.11% (155 patients). Primary BSI patients were younger and predominantly nosocomial, whereas secondary BSI was mostly community-acquired. Clinical severity scores (SOFA, APACHE II, SAPS, and qPitt) were significantly higher in primary compared to secondary BSI. The median hospital stay was longer for primary BSI (21 vs. 12 days, p < 0.001). Although not statistically significant, mortality rates were higher in primary BSI (43.24% vs. 26.09%). Total care costs were significantly higher for primary BSI (EUR 4388.3 vs. EUR 2530.25, p = 0.016), driven by longer hospital stays and increased antibiotic costs. This study underscores the distinct clinical and economic challenges of primary versus secondary BSI and emphasizes the need for prompt diagnosis and tailored antimicrobial therapy. Further research should focus on developing specific management guidelines for primary BSI and exploring interventions to reduce BSI burden across healthcare settings.
Keywords: bloodstream infections; bacteremia; primary bacteremia; secondary bacteremia; clinical outcomes; mortality; hospitalization costs; antibiotic therapy; nosocomial infections; community-acquired infections bloodstream infections; bacteremia; primary bacteremia; secondary bacteremia; clinical outcomes; mortality; hospitalization costs; antibiotic therapy; nosocomial infections; community-acquired infections

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MDPI and ACS Style

Chandroulis, I.; Schinas, G.; de Lastic, A.-L.; Polyzou, E.; Tsoupra, S.; Davoulos, C.; Kolosaka, M.; Niarou, V.; Theodoraki, S.; Ziazias, D.; et al. Patterns, Outcomes and Economic Burden of Primary vs. Secondary Bloodstream Infections: A Single Center, Cross-Sectional Study. Pathogens 2024, 13, 677. https://doi.org/10.3390/pathogens13080677

AMA Style

Chandroulis I, Schinas G, de Lastic A-L, Polyzou E, Tsoupra S, Davoulos C, Kolosaka M, Niarou V, Theodoraki S, Ziazias D, et al. Patterns, Outcomes and Economic Burden of Primary vs. Secondary Bloodstream Infections: A Single Center, Cross-Sectional Study. Pathogens. 2024; 13(8):677. https://doi.org/10.3390/pathogens13080677

Chicago/Turabian Style

Chandroulis, Ioannis, Georgios Schinas, Anne-Lise de Lastic, Eleni Polyzou, Stamatia Tsoupra, Christos Davoulos, Martha Kolosaka, Vasiliki Niarou, Spyridoula Theodoraki, Dimitrios Ziazias, and et al. 2024. "Patterns, Outcomes and Economic Burden of Primary vs. Secondary Bloodstream Infections: A Single Center, Cross-Sectional Study" Pathogens 13, no. 8: 677. https://doi.org/10.3390/pathogens13080677

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