Background Bloodstream infections (BSIs) are an emerging cause of significant morbidity and mortality in severe Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill COVID-19 patients. Methods This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age > 18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 admitted in the intensive care unit (ICU) were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs. Results Out of 750 patients admitted in COVID ICU, 8.5% developed secondary BSIs. All severe COVID-19 patients who developed BSIs succumbed to illness. A significant proportion of BSIs were Gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate, followed by Klebsiella pneumoniae (32.8% and 21.9%, respectively). Multidrug-resistance organisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of Gram-negative bacteria resistant to carbapenems was 47.2% (25/53). On multivariate analysis, raised total leukocyte counts, mechanical ventilation and presence of comorbidities were significantly associated with the incidence of BSIs. Conclusion We found a significant prevalence of Acinetobacter baumannii in COVID-19 associated BSIs. The presence of comorbidities raised leukocyte counts and mechanical ventilation should alarm clinicians for possible BSIs. The timely initiation of empirical antibiotics and rapid de-escalation is vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.

Background: Bloodstream infections (BSIs) are emerging cause of significant morbidity and mortality in severe Corona virus disease (Covid-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill Covid-19 disease. Material and Methods: This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All the patients (age >18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed Covid-19 pneumonia admitted in Covid intensive care unit (ICU) between September 2020 to February 2021 were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs.Results: Out of 750 patients admitted in Covid ICU, 8.5% developed secondary BSIs. All severe Covid-19 pneumonia patients developed BSIs succumbed to illness. The major proportion of BSIs were gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate followed by Klebsiella pneumoniae (32.8% and 21.9% respectively). Multidrug-resistance microorganisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of gram-negative bacteria resistant to carbapenems was 47.2% (25/53). Conclusion: BSIs in severe Covid-19 patients carries a substantial mortality, which is a cause for concern. Timely initiation of empirical antibiotics and prompt de-escalation are vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.

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