{"id":23621,"date":"2023-03-28T04:06:00","date_gmt":"2023-03-27T20:06:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23621"},"modified":"2023-03-28T05:52:08","modified_gmt":"2023-03-27T21:52:08","slug":"intensive-care-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9aicu%e6%82%a3%e8%80%85%e5%8c%bb%e9%99%a2%e8%8e%b7%e5%be%97%e6%80%a7%e8%a1%80%e8%a1%8c%e6%80%a7%e6%84%9f%e6%9f%93%e7%9a%84%e6%b5%81","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23621","title":{"rendered":"[Intensive Care Med\u53d1\u8868\u8bba\u6587]\uff1aICU\u60a3\u8005\u533b\u9662\u83b7\u5f97\u6027\u8840\u884c\u6027\u611f\u67d3\u7684\u6d41\u884c\u75c5\u5b66\u53ca\u9884\u540e"},"content":{"rendered":"\n<ul>\n<li>Original<\/li>\n\n\n\n<li><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s00134-022-06944-2#article-info\">Published:&nbsp;<time datetime=\"2023-02-10\">10 February 2023<\/time><\/a><\/li>\n<\/ul>\n\n\n\n<h1 class=\"wp-block-heading\">Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Alexis Tabah,\u00a0Niccol\u00f2 Buetti,\u00a0Quentin Staiquly,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Intensive Care Med (2023). https:\/\/doi.org\/10.1007\/s00134-022-06944-2<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"Abs1\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Purpose<\/h3>\n\n\n\n<p>In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Methods<\/h3>\n\n\n\n<p>We carried out a prospective international cohort study of adult patients (\u2265\u200918&nbsp;years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Results<\/h3>\n\n\n\n<p>2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp<em>.<\/em>\u00a0(20.3%),\u00a0<em>Escherichia coli<\/em>\u00a0(15.8%), and Pseudomonas spp<em>.<\/em>\u00a0(14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was\u00a0present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24\u00a0h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive\u00a0from hospital by day-28.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-022-06944-2\/MediaObjects\/134_2022_6944_Fig1_HTML.png?as=webp\" alt=\"\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Conclusions<\/h3>\n\n\n\n<p>HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.<\/p>\n\n\n\n<p>Take-home message<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>In this study, hospital-acquired bloodstream infections were frequently caused by Gram-negative, carbapenem resistant or with difficult to treat resistance pathogens. Antibiotic resistance was associated with delays to antimicrobial therapy. Mortality was 37% at day-28.<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Epidemiology and outcomes of hospital-acquired bloodstr [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23621"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23621"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23621\/revisions"}],"predecessor-version":[{"id":23622,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23621\/revisions\/23622"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23621"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23621"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23621"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}