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Volume 10
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10.3390/microorganisms10071314
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Article

Bloodstream Infections in a COVID-19 Non-ICU Department: Microbial Epidemiology, Resistance Profiles and Comparative Analysis of Risk Factors and Patients’ Outcome

by
Efthymia Giannitsioti
1,2,*,
Christina Louka
3,
Vasiliki Mamali
3,
Elisavet Kousouli
4,
Lemonia Velentza
1,5,
Vaia Papadouli
3,
Georgios Loizos
1,6,
Panagiotis Mavroudis
1,6,
Georgios Kranidiotis
1,
Nektaria Rekleiti
3,
Alexandra Stamati
1,
Ioannis Speggos
1,6,
Ioannis Daniil
3,
Panagiotis Kouvatsos
1,
Chrysanthi Sidiropoulou
1,6,
Garifallia Linardaki
1,6,
Styliani Gerakari
1,5,
Georgios Chrysos
1,4,6,
Katina Themeli-Digalaki
3,4 and
Olympia Zarkotou
3,4
1
COVID-19 Department, Tzaneio General Hospital, 18536 Piraeus, Greece
2
Fourth Department of Internal Medicine, NKUA, ATTIKON University General Hospital, 12462 Athens, Greece
3
Department of Microbiology, Tzaneio General Hospital, 18536 Piraeus, Greece
4
Infection Control Action Team, Tzaneio General Hospital, 18536 Piraeus, Greece
5
Emergency Department, Tzaneio General Hospital, 18536 Piraeus, Greece
6
Second Department of Internal Medicine, Tzaneio General Hospital, 18536 Piraeus, Greece
*
Author to whom correspondence should be addressed.
Microorganisms 2022, 10(7), 1314; https://doi.org/10.3390/microorganisms10071314
Submission received: 29 April 2022 / Revised: 5 June 2022 / Accepted: 24 June 2022 / Published: 29 June 2022
(This article belongs to the Special Issue Emerging Infectious Diseases and Strategies for Their Prevention and Control)
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Abstract

Background: Bloodstream infections (BSI) caused by highly resistant pathogens in non-ICU COVID-19 departments pose important challenges. Methods: We performed a comparative analysis of incidence and microbial epidemiology of BSI in COVID-19 vs. non-COVID-19, non-ICU departments between 1 September 2020-31 October 2021. Risk factors for BSI and its impact on outcome were evaluated by a case-control study which included COVID-19 patients with/without BSI. Results: Forty out of 1985 COVID-19 patients developed BSI. The mean monthly incidence/100 admissions was 2.015 in COVID-19 and 1.742 in non-COVID-19 departments. Enterococcus and Candida isolates predominated in the COVID-19 group (p < 0.001 and p = 0.018, respectively). All Acinetobacter baumannii isolates were carbapenem-resistant (CR). In the COVID-19 group, 33.3% of Klebsiella pneumoniae was CR, 50% of Escherichia coli produced ESBL and 19% of Enterococcus spp. were VRE vs. 74.5%, 26.1% and 8.8% in the non-COVID-19 group, respectively. BSI was associated with prior hospitalization (p = 0.003), >2 comorbidities (p < 0.001), central venous catheter (p = 0.015), severe SARS-CoV-2 pneumonia and lack of COVID-19 vaccination (p < 0.001). In the multivariate regression model also including age and multiple comorbidities, only BSI was significantly associated with adverse in-hospital outcome [OR (CI95%): 21.47 (3.86–119.21), p < 0.001]. Conclusions: BSI complicates unvaccinated patients with severe SARS-CoV-2 pneumonia and increases mortality. BSI pathogens and resistance profiles differ among COVID-19/non-COVID-19 departments, suggesting various routes of pathogen acquisition.
Keywords: COVID-19; SARS-CoV-2 pneumonia; bloodstream infections; bacteremia; fungemia; catheter-related bloodstream infection; antimicrobial resistance; multidrug resistant organisms COVID-19; SARS-CoV-2 pneumonia; bloodstream infections; bacteremia; fungemia; catheter-related bloodstream infection; antimicrobial resistance; multidrug resistant organisms

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MDPI and ACS Style

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

AMA Style

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 Style

Giannitsioti, 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

APA Style

Giannitsioti, E., Louka, C., Mamali, V., Kousouli, E., Velentza, L., Papadouli, V., Loizos, G., Mavroudis, P., Kranidiotis, G., Rekleiti, N., Stamati, A., Speggos, I., Daniil, I., Kouvatsos, P., Sidiropoulou, C., Linardaki, G., Gerakari, S., Chrysos, G., Themeli-Digalaki, K., & Zarkotou, O. (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(7), 1314. https://doi.org/10.3390/microorganisms10071314

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