Epidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: A prospective observational cohort study

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dc.authorid0000-0001-8022-7325
dc.contributor.authorAslan, Abdullah Tarık
dc.contributor.authorTabah, Alexis
dc.contributor.authorKoylu, Bahadır
dc.contributor.authorKöylü, Bahadır
dc.contributor.authorKaya Kalem, Ayşe
dc.contributor.authorAksoy, Firdevs
dc.contributor.authorErol, Çiğdem
dc.contributor.authorKaraali, Rıdvan
dc.contributor.authorTunay, Burcu
dc.contributor.authorGüzeldağ, Seda
dc.contributor.authorBatirel, Ayşe
dc.contributor.authorDindar, Emine Kübra
dc.contributor.authorAkdoğan, Özlem
dc.contributor.authorBilir, Yeliz
dc.contributor.authorAkova, Murat
dc.date.accessioned2023-07-21T11:14:59Z
dc.date.available2023-07-21T11:14:59Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
dc.description.abstractOBJECTIVES: To uncover clinical epidemiology, microbiological characteristics and outcome determinants of hospital-acquired bloodstream infections (HA-BSIs) in Turkish ICU patients. METHODS: The EUROBACT II was a prospective observational multicontinental cohort study. We performed a subanalysis of patients from 24 Turkish ICUs included in this study. Risk factors for mortality were identified using multivariable Cox frailty models. RESULTS: Of 547 patients, 58.7% were male with a median [IQR] age of 68 [55-78]. Most frequent sources of HA-BSIs were intravascular catheter [182, (33.3%)] and lower respiratory tract [175, (32.0%)]. Among isolated pathogens (n?=?599), 67.1% were Gram-negative, 21.5% Gram-positive and 11.2% due to fungi. Carbapenem resistance was present in 90.4% of Acinetobacter spp., 53.1% of Klebsiella spp. and 48.8% of Pseudomonas spp. In monobacterial Gram-negative HA-BSIs (n?=?329), SOFA score (aHR 1.20, 95% CI 1.14-1.27), carbapenem resistance (aHR 2.46, 95% CI 1.58-3.84), previous myocardial infarction (aHR 1.86, 95% CI 1.12-3.08), COVID-19 admission diagnosis (aHR 2.95, 95% CI 1.25-6.95) and not achieving source control (aHR 2.02, 95% CI 1.15-3.54) were associated with mortality. However, availability of clinical pharmacists (aHR 0.23, 95% CI 0.06-0.90) and source control (aHR 0.46, 95% CI 0.28-0.77) were associated with survival. In monobacterial Gram-positive HA-BSIs (n?=?93), SOFA score (aHR 1.29, 95% CI 1.17-1.43) and age (aHR 1.05, 95% CI 1.03-1.08) were associated with mortality, whereas source control (aHR 0.41, 95% CI 0.20-0.87) was associated with survival. CONCLUSIONS: Considering high antimicrobial resistance rate, importance of source control and availability of clinical pharmacists, a multifaceted management programme should be adopted in Turkish ICUs.
dc.description.sponsorshipEuropean Society of Intensive Care Medicine (ESICM) (ESICM Trials Group Awards 2018) ; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) (ESCMID Study Group Research Grants 2018) study Group for Infections in Critically Ill Patients (ESGCIP) ; Norva Dahlia (2018 Norva Dahlia study grant) foundation ; Redcliffe Hospital Private Practice Trust Funden_US
dc.identifier.citationAslan, A. T., Tabah, A., Koylu, B., Köylü, B., Kaya Kalem, A., Aksoy, F. ... Akova, M. (2023). Epidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: A prospective observational cohort study. The Journal of Antimicrobial Chemotherapy, 78(2), 1757-1768. https://dx.doi.org/10.1093/jac/dkad167
dc.identifier.doi10.1093/jac/dkad167
dc.identifier.endpage1768
dc.identifier.issn0305-7453
dc.identifier.issn1460-2091
dc.identifier.issue2
dc.identifier.pmid37264485
dc.identifier.scopus2-s2.0-85164237060
dc.identifier.scopusqualityQ1
dc.identifier.startpage1757
dc.identifier.urihttps://dx.doi.org/10.1093/jac/dkad167
dc.identifier.urihttps://hdl.handle.net/20.500.12511/11237
dc.identifier.volume78
dc.identifier.wos000999638800001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorTunay, Burcu
dc.institutionauthorYılmaz, Mesut
dc.language.isoen
dc.publisherNLM (Medline
dc.relation.ispartofThe Journal of Antimicrobial Chemotherapyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectBloodstream Infection
dc.subjectTurkish Intensive Care Units
dc.subject28-Day Mortality
dc.titleEpidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: A prospective observational cohort study
dc.typeArticle

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