Microbiologic characteristics and predictors of mortality in bloodstream infections in intensive care unit patients: A 1-year, large, prospective surveillance study in 5 Italian hospitals

Diego Delle Rose, Pasquale Sordillo, Sabina Gini, Carlotta Cerva, Stefano Boros, Giovanni Rezza, Marcello Meledandri, Maria Teresa Gallo, Grazia Prignano, Roberta Caccese, Mario D'Ambrosio, Giorgia Citterio, Monica Rocco, Francesca Leonardis, Silvia Natoli, Carla Fontana, Marco Favaro, Maria Grazia Celeste, Tiziana Franci, Gian Piero TestoreMassimo Andreoni, Loredana Sarmati

Research output: Contribution to journalArticle

Abstract

Background Bloodstream infections (BSIs) from multidrug-resistant (MDR) bacteria cause morbidity and mortality in intensive care unit (ICU) patients worldwide. This study investigated the incidence of BSIs in 5 adult general ICUs in Rome, Italy, and evaluated the mortality rate and risk factors associated with these infections. Methods Over a 12-month period, 1,318 patients were enrolled. Demographic characteristics, Simplified Acute Physiology Score II (SAPS II), comorbidities, and BSI isolate data were collected. After stratification for the outcome, statistical analysis was performed to assess the impact of patient risk factors on in-hospital mortality. Results There were 324 BSIs in 175 patients recorded, with an in-hospital mortality rate of 46%. Univariate analysis revealed that SAPS II, cardiac comorbidity, and Klebsiella pneumoniae BSI were significantly associated with a higher risk of death. Having a K pneumoniae BSI and cardiac illness at admission were both confirmed to be associated with death by multivariate analysis (P =.0162 and P =.0158, respectively). Most of the K pneumoniae isolates showed high resistance rates to carbapenems. Conclusion BSIs caused by K pneumoniae and cardiovascular comorbidity in ICU patients are associated with a higher risk of death. Thorough surveillance for MDR pathogens and stratification of the patients' risk on admission into the ICU are key to improving the outcomes of these infections.

Original languageEnglish
Pages (from-to)1178-1183
Number of pages6
JournalAJIC: American Journal of Infection Control
Volume43
Issue number11
DOIs
Publication statusPublished - Nov 1 2015

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Keywords

  • Bloodstream infections
  • Intensive care unit
  • Klebsiella pneumoniae
  • Microbiology
  • Mortality
  • Predictors

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Health Policy

Cite this

Delle Rose, D., Sordillo, P., Gini, S., Cerva, C., Boros, S., Rezza, G., Meledandri, M., Gallo, M. T., Prignano, G., Caccese, R., D'Ambrosio, M., Citterio, G., Rocco, M., Leonardis, F., Natoli, S., Fontana, C., Favaro, M., Celeste, M. G., Franci, T., ... Sarmati, L. (2015). Microbiologic characteristics and predictors of mortality in bloodstream infections in intensive care unit patients: A 1-year, large, prospective surveillance study in 5 Italian hospitals. AJIC: American Journal of Infection Control, 43(11), 1178-1183. https://doi.org/10.1016/j.ajic.2015.06.023