Bloodstream infections (BSI) in COVID-19 patients admitted to a tertiary care hospital: A retrospective study

Abstract

Bloodstream infections (BSIs) may cause significant adverse clinical outcomes among patients affected by Coronavirus disease 2019 (COVID-19). This study was conducted with the objective to characterize the bacterial isolates and their susceptibility pattern and to document the patient outcome as well as skin disinfection measures followed during the venepuncture for the blood collection procedure.All blood cultures received from COVID-19 patients admitted in various COVID care wards and ICUs for a period of two years from June 2020 to May 2022 were included in the study. An automated BacT/ALERT system was used for blood culture. The microbial identification and antimicrobial susceptibility testing were done by standard methods. Patient demographic and treatment details and infection control and prevention practices followed during the blood specimen collection were documented.Out of 172 COVID-19-positive patients blood samples were sent for blood culture with clinical suspicion of sepsis. Out of these, 4.2% were positive. The median age of COVID-19 patients with positive blood cultures was 55 years and about 67% of patients had associated comorbidities. About 31% of patients were admitted to ICUs for their management. The blood culture positivity was documented more among patients with ICU admission, underlying comorbidities, and the presence of an indwelling device. Gram-positive bacterial isolation was more than gram-negative bacteria. About 54% showed clinical improvement at the time of discharge and death was recorded in 19% of patients. There was a lack of strict adherence to the aseptic techniques during the venepuncture for blood collection.The incidence of bloodstream infections documented was low for COVID-19 patients. Hence, empirical antimicrobial agents should be used with care and prompt discontinuation should be done on clinical improvement and based on the microbiology culture report.