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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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    The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: A multinational study
    (Springer, 2015) Arslan, Ferhat; Meynet, Elodie; Sünbül, Mustafa; Sipahi, Oğuz Reşat; Kurtaran, Behice; Kaya, Selçuk; İnkaya, Ahmet; Pagliano, Pasquale; Şengöz, Gönül; Batırel, Ayşe; Kayaaslan, Bircan; Yıldız, Orhan; Güven, Tümer; Türker, Nesrin; Midi, İpek; Parlak, Emine; Tosun, Selma; Erol, Serpil; İnan, Asuman; Öztoprak, Nefise; Balkan, İlker; Aksoy, Y.; Ceylan, Bahadır; Yılmaz, Mesut; Mert, Ali
    The aim of this study was to determine the independent risk factors, morbidity, and mortality of central nervous system (CNS) infections caused by Listeria monocytogenes. We retrospectively evaluated 100 episodes of neuroinvasive listeriosis in a multinational study in 21 tertiary care hospitals of Turkey, France, and Italy from 1990 to 2014. The mean age of the patients was 57 years (range, 19-92 years), and 64% were males. The all-cause immunosuppression rate was 54 % (54/100). Forty-nine (49 %) patients were referred to a hospital because of the classical triad of symptoms (fever, nuchal rigidity, and altered level of consciousness). Rhombencephalitis was detected radiologically in 9 (9 %) cases. Twenty-seven (64 %) of the patients who had cranial magnetic resonance imaging (MRI) performed had findings of meningeal and parenchymal involvement. The mean delay in the initiation of specific treatment was 6.8 +/- 7 days. Empiric treatment was appropriate in 52 (52 %) patients. The mortality rate was 25 %, while neurologic sequelae occurred in 13 % of the patients. In the multivariate analysis, delay in treatment [odds ratio (OR), 1.07 [95 % confidence interval (CI), 1.01-1.16]] and seizures (OR, 3.41 [95 % CI, 1.05-11.09]) were significantly associated with mortality. Independent risk factors for neurologic sequelae were delay in treatment (OR, 1.07 [95 % CI, 1.006-1.367]) and presence of bacteremia (OR, 45.2 [95 % CI, 2.73-748.1]). Delay in the initiation of treatment of neuroinvasive listeriosis was a poor risk factor for unfavorable outcomes. Bacteremia was one of the independent risk factors for morbidity, while the presence of seizures predicted worse prognosis. Moreover, the addition of aminoglycosides to ampicillin monotherapy did not improve patients' prognosis.