Bloodstream infections in the COVID-19 era: results from an Italian multi-centre study

Background: Correlation between coronavirus disease 2019 (COVID-19) and superinfections has been in-vestigated, but remains to be fully assessed. This multi-centre study reports the impact of the pandemic on bloodstream infections (BSIs). Methods: This study included all patients with BSIs admitted to four Italian hospitals between 1 January and 30 June 2020. Clinical, demographic and microbiologic data were compared with data for patients hospitalized during the same period in 2019. Results: Among 26,012 patients admitted between 1 January and 30 June 2020, 1182 had COVID-19. Among the patients with COVID-19, 107 BSIs were observed, with an incidence rate of 8.19 episodes per 10 0 0 patient-days. The incidence of BSI was significantly higher in these patients compared with patients without COVID-19 (2.72/10 0 0 patient-days) and patients admitted in 2019 (2.76/10 0 0 patient-days). In comparison with patients without COVID-19, BSI onset in patients with COVID-19 was delayed during the course of hospitalization (16.0 vs 5 days, respectively). Thirty-day mortality among patients with COVID-19 was 40.2%, which was significantly higher compared with patients without COVID-19 (23.7%). BSIs in patients with COVID-19 were frequently caused by multi-drug-resistant pathogens, which were often centre-dependent. Conclusions: BSIs are a common secondary infection in patients with COVID-19, characterized by in-creased risk during hospitalization and potentially burdened with high mortality. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )