During the study period, 19,785 patients were admitted, and BSIs were present at ICU admission in 726 patients (mean APACHE II score, 21 ± 8; mean age, 61 ± 15 years). BSIs were classified as CABs in 47.2% of patients (343 of 726), as HABs in 34.7% (252 of 726), and as HCABs in 18% (131 of 726).
Clinical characteristics were different among the BSI subgroups (Table 1). Among patients with HCABs, 51% had been hospitalized in an acute-care hospital before the BSI, 25.2% had attended dialysis or received IV chemotherapy, 22.1% had received health care at home, and 9.2% had resided in a nursing home or longterm-care facility. Some patients presented with more than one factor defining the condition of HCAB.
Globally, the most common sources of BSI were lower respiratory tract infections and intraabdominal infections (Table 2). Respiratory tract infection was the most frequent source in CABs, whereas abdominal infection was the most frequent source in HCABs and HABs.
The distribution of pathogens was significantly different among the BSI subgroups (Table 3). PARPs (ESKAPE microorganisms) were more frequent in HABs (34.8%) and HCABs (27.6%) than in CABs (10.3%) (P < .001). To identify the risk factors independently associated with the isolation of PARPs, we fitted a multivariate logistic regression model, including as covariates age, sex, and APACHE II score at admission, to address cases with more than two comorbidities, systemic response, source, and origin of BSI.
Table 1—Patient Demographics and Clinical Characteristics by Type of BSI
|Characteristic||(n = 343)||(n = 131)||(n = 252)|
|Age, y, mean (SD)||60 (16)||64 (13)a||62 (14)|
|APACHE II score,||19 (9)||23 (9)b||21 (9)|
|mean (SD) Comorbidities, %|
|Chronic hepatic failure||9.6||7.6||10.3|
|Chronic renal failure||5.8||13.0a||9.1|