Differences in the epidemiology, clinical characteristics, distribution of microorganisms and outcomes between COVID-19 patients and non-COVID-19 patients with ICU- associated BSIs: a one-center retrospective study

Background We aimed to study the differences between patients with COVID-19 and non-COVID-19 ICU-associated BSIs in terms of epidemiological, clinical, microbiological and outcome data. Methods Patients who developed BSI >48 hours after admission to the ICU among patients with COVID-19 and non-COVID-19 who were followed during a two-year pandemic period at a university hospital in the ICU were selected. Descriptive statistics were used for differences between patients with COVID-19 and without COVID-19. Logistic regression analysis was used to determine mortality risk factors in BSI patients. Results Infection of the lower respiratory tract was much more common in COVID-19 patients (43.3% to 26%, p =0,000). The abundance of Acinetobacter baumanii , a microorganism causing BSI was significantly greater in COVID-19 patients than in non-COVID-9 patients (5.6% to 24.4%; p = 0.000), and the prevalence of Gram-negative MDR bacteria (61.7 to 81.7%, p = 0.020) was greater. The duration of antibiotic use in the hospital was associated with the BSI, where Gram-negative MDR bacteria are active (p = 0,000), and the appropriateness of empirical treatment (p = 0.031) was more common in the COVID-19 group. In our study, we discovered that patients with COVID-19 had lower levels of acute-phase reagents commonly used for BSI but more severe clinical symptoms during BSI. COVID-19 survivors had shorter survival times after BSI (p = 0.032) than non-COVID-19 survivors. Conclusions The increased use of antibiotics in hospitals for patients with severe COVID-19 and deficiencies in infection control measures have led to an increase in MDR microorganisms.