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.authoridAkdogan, Özlem/0000-0003-2969-474X
dc.authoridTimuroğlu, Arif/0000-0003-4100-5505
dc.authoridErol, Çiğdem/0000-0002-2535-2534
dc.authoridEroglu, Ahmet/0000-0002-0396-1582
dc.authoridGöksu, şenay/0000-0001-8197-0620
dc.authoridKAYA KALEM, Ayse/0000-0002-4759-0066
dc.authoridKARAALİ, Rıdvan/0000-0003-2440-7529
dc.authorwosidBuetti, Niccolo/ABC-3196-2022
dc.authorwosidAkdogan, Özlem/ADK-3714-2022
dc.authorwosidçağan aktaş, sabahat/IYS-1021-2023
dc.authorwosidTimuroğlu, Arif/JJF-4880-2023
dc.authorwosidErol, Çiğdem/AAJ-1219-2021
dc.authorwosidEroglu, Ahmet/B-1414-2012
dc.authorwosidDag, Osman/S-5379-2016
dc.contributor.authorAslan, Abdullah Tarik
dc.contributor.authorTabah, Alexis
dc.contributor.authorKoylu, Bahadir
dc.contributor.authorKalem, Ayse Kaya
dc.contributor.authorAksoy, Firdevs
dc.contributor.authorErol, Cigdem
dc.contributor.authorKaraali, Ridvan
dc.date.accessioned2024-08-04T20:54:29Z
dc.date.available2024-08-04T20:54:29Z
dc.date.issued2023
dc.departmentİnönü Üniversitesien_US
dc.description.abstractSynopsis Objectives 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.en_US
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.description.sponsorshipResearch grants were obtained from the European Society of Intensive Care Medicine (ESICM) (ESICM Trials Group Awards 2018), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) (ESCMID Study Group Research Grants 2018) study Group for Infections in Critically Ill Patients (ESGCIP), the Norva Dahlia (2018 Norva Dahlia study grant) foundation and the Redcliffe Hospital Private Practice Trust Fund. These Funding sources had no role in study design, the collection, analysis and interpretation of data, writing of the manuscript and the decision to submit the article for publication.en_US
dc.identifier.doi10.1093/jac/dkad167
dc.identifier.endpage1768en_US
dc.identifier.issn0305-7453
dc.identifier.issn1460-2091
dc.identifier.issue7en_US
dc.identifier.pmid37264485en_US
dc.identifier.scopus2-s2.0-85164237060en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1757en_US
dc.identifier.urihttps://doi.org/10.1093/jac/dkad167
dc.identifier.urihttps://hdl.handle.net/11616/101453
dc.identifier.volume78en_US
dc.identifier.wosWOS:000999638800001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.relation.ispartofJournal of Antimicrobial Chemotherapyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCritically-Ill Patientsen_US
dc.subjectSepsisen_US
dc.subjectScoreen_US
dc.subjectIcuen_US
dc.titleEpidemiology and risk factors of 28-day mortality of hospital-acquired bloodstream infection in Turkish intensive care units: a prospective observational cohort studyen_US
dc.typeArticleen_US

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