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    Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: A descriptive analysis of the Eurobact II study
    (BioMed Central Ltd, 2022) Buetti, Niccolò; Tabah, Alexis; Loiodice, Ambre; Ruckly, Stéphane; Aslan, Abdullah Tarık; Montrucchio, Giorgia; Cortegiani, Andrea; Saltoğlu, Neşe; Kayaaslan, Bircan; Aksoy, Firdevs; Murat, Akova; Akdoğan, Özlem; Saraçoğlu, Kemal Tolga; Erdoğan, Cem; Leone, Marc; Ferrer, Ricard; Paiva, José-Artur; Hayashi, Yoshiro; Ramanan, Mahesh; Conway Morris, Andrew; Barbier, François; Timsit, Jean-François; Lipman, Jeffrey; Litton, Edward; Palermo, Anna Maria; Yap, Timothy; Eroğlu, Ege; Hosokawa, Koji; Yoshida, Hideki; Fujitani, Shigeki; Zand, Farid; Mahmoodpoor, Ata; Tabatabaei, Seyed Mohammad Nasirodin; Elrabi, Omar; Almekhlafi, Ghaleb A.; Vidal, Gabriela; Aparicio, Marta; Alonzo, Irene; Namendys-Silva, Silvio A.; Hermosillo, Mariana; Castillo, Roberto Alejandro; De Bus, Liesbet; De Waele, Jan; Hollevoet, Isabelle; De Schryver, Nicolas; Serck, Nicolas; Kovacevic, Pedja; Zlojutro, Biljana; Ruppe, Etienne; Montravers, Philippe; Dulac, Thierry; Castanera, Jérémy; Massri, Alexandre; Guesdon, Charlotte; Garcon, Pierre; Duprey, Matthieu; Philippart, François; Tran, Marc; Bruel, Cédric; Kalfon, Pierre
    Background: The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients. Methods: We 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. Results: A 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). Conclusions: We 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.
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    Factors affecting mortality in covid-19-associated pulmonary aspergillosis: an international ID-IRI study
    (2024) Şahin, Meyha; Yılmaz, Mesut; Mert, Ali; Emecen, Ahmet Naci; Rahman S. Al Maslamani, Muna A.; Mahmoud A. Hashim, Samar; Ittaman, Ajithkumar Valooparambil; Wadi Al Ramahi, Jamal; Gergely Szabo, Balint; Konopnicki, Deborah; Başkol Elik, Dilşah; Lakatos, Botond; Sipahi, Oğuz Reşat; Khedr, Reham; Jalal, Sabah; Pshenichnaya, Natalia; Magdalena, Dumitru Irina; El Kholy, Amani; Khan, Ejaz Ahmed; Alkan, Sevil; Hakamifard, Atousa; Sincan, Gülden; Esmaoğlu, Aliye; Makek, Mateja Jankovic; Gürbüz, Esra; Liskova, Anna; Albayrak, Ayşe; Stebel, Roman; Ünver Ulusoy, Tülay; Ripon, Rezaul Karim; Moroti, Ruxandra; Dascalu, Cosmin; Rashid, Naveed; Cortegiani, Andrea; Bahadır, Zeynep; Erdem, Hakan
    Background: This study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA). Methods: In this cross-sectional study, data from 23 centers across 15 countries, spanning the period of March 2020 to December 2021, were retrospectively collected. The study population comprised patients who developed invasive pulmonary aspergillosis while being treated for COVID-19 in the intensive care unit. Cox regression and decision tree analyses were used to identify factors associated with mortality in patients with CAPA. Results: A total of 162 patients (males, 65.4 %; median age: 64 [25th–75th: 54.0–73.8] years) were included in the study, of whom 113 died during the 90-day follow-up period. The median duration from CAPA diagnosis to death was 12 (25th–75th: 7–19) days. In the multivariable Cox regression model, an age of ?65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37–3.07), requiring vasopressor therapy at the time of CAPA diagnosis (HR: 1.80, 95 % CI: 1.17–2.76), and receiving renal replacement therapy at the time of CAPA diagnosis (HR: 2.27, 95 % CI: 1.35–3.82) were identified as predictors of mortality. Decision tree analysis revealed that patients with CAPA aged ?65 years who received corticosteroid treatment for COVID-19 displayed higher mortality rates (estimated rate: 1.6, observed in 46 % of patients). Conclusion: This study concluded that elderly patients with CAPA who receive corticosteroids are at a significantly higher risk of mortality, particularly if they experience multiorgan failure.