Survival Impact and Clinical Predictors of Acute Gastrointestinal Bleeding in Patients With Bloodstream Infection

Abstract

Purpose: The impact of gastrointestinal bleeding (GIB) on outcomes of patients with bloodstream infection (BSI) has not been studied. We aim to evaluate the risk factors and survival impact of GIB on the outcome of BSI. Materials and Methods: This study was conducted prospectively at National Taiwan University Hospital Yunlin Branch between January 1, 2015, and December 31, 2016. Patients aged ≥18 years for who BSI was confirmed by blood cultures were enrolled and followed for 90 days. Risk factors of GIB were identified by univariable and multivariable logistic regression models. The survival impact of GIB on BSI was evaluated with the Cox proportional hazards model with inverse probability of treatment weighting. Results: Of the 1034 patients with BSI, 79 (7.64%) developed acute GIB. We identified 5 independent predictors of GIB. Patients with BSI complicated with GIB had an increased 90-day mortality compared to patients without GIB (hazard ratio 1.74, 95% confidence interval: 1.14, 2.65). Conclusions: Gastrointestinal bleeding had an adverse impact on the short-term survival in patients with BSI. The clinical predictors may help identify patients who may benefit from active prevention and treatment of GIB.

Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China

“…Therefore, careful attention should be paid to the use of tigecycline in ICU patients. The gastrointestinal tract has long been considered to have an important regulatory role 15 , and BSI patients with gastrointestinal bleeding has higher in-hospital mortality 16 , 17 . The result of our research also found a significant correlation between gastrointestinal bleeding and the occurrence of BSI, supporting the previous findings.…”

Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study

“…A study by Amy et al showed that gastrointestinal bleeding had a negative impact on the short-term survival of patients with BSI. 37 However, the underlying mechanism remains unclear, and more studies are needed in the future.…”

Bacterial vampirism mediated through taxis to serum

“…Although severe GI bleeding isn't a typical outcome of enteric infection, it is a substantial burden on human health, affecting around 40-150 out of every 100,000 individuals annually, with a fatality rate ranging from 6% to 30% (Fig. 1) 3,13,[18][19][20][20][21][22][23] . Enterobacteriaceae are prone to bloodstream entry and are a leading cause of sepsis-related deaths in individuals with inflammatory bowel diseases (IBD) that have recurrent enterohemorrhagic lesions 24,25 .…”

“…More broadly, GI bleeding is associated with significant risk of mortality, in the range of 6-30%, and impacts 40-150 of every 100,000 individuals annually (Fig. 1) (Aljarad and Mobayed, 2021;Huang et al, 2021;Kim et al, 2014Kim et al, , 2014Moledina and Komba, 2017;Saltzman, 2022;Scales and Huffnagle, 2013;Tacconelli et al, 2018;Zhou et al, 2022). GI pathogens demonstrate specific affinity for inflamed and damaged tissue (Fig.…”