@article{01HQTJ26P7EB2XAHK0Q2P9N7BT,
  abstract     = {{PurposeIn 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.MethodsWe carried out a prospective international cohort study of adult patients (>= 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021.Results2600 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. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h 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 from hospital by day-28.ConclusionsHA-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.}},
  author       = {{Tabah, Alexis and  Buetti, Niccolo and  Staiquly, Quentin and  Ruckly, Stephane and  Akova, Murat and  Aslan, Abdullah Tarik and  Leone, Marc and  Morris, Andrew Conway and  Bassetti, Matteo and  Arvaniti, Kostoula and  Lipman, Jeffrey and  Ferrer, Ricard and  Qiu, Haibo and  Paiva, Jose-Artur and  Povoa, Pedro and De Bus, Liesbet and De Waele, Jan and  Zand, Farid and  Gurjar, Mohan and  Alsisi, Adel and  Abidi, Khalid and  Bracht, Hendrik and  Hayashi, Yoshiro and  Jeon, Kyeongman and  Elhadi, Muhammed and  Barbier, Francois and  Timsit, Jean-Francois and Study Grp, EUROBACT-2 and Network, ESICM and Network, ESCMID and Network, ESGCIP and Network, OUTCOMEREA}},
  issn         = {{0342-4642}},
  journal      = {{INTENSIVE CARE MEDICINE}},
  keywords     = {{antibiotic resistance,hospital-acquired,bacteremia,bloodstream infection}},
  language     = {{eng}},
  pages        = {{178--190}},
  title        = {{Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients : the EUROBACT-2 international cohort study}},
  url          = {{http://doi.org/10.1007/s00134-022-06944-2}},
  volume       = {{49}},
  year         = {{2023}},
}

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