Evaluation of Clinical Outcomes, Pathogens, and Antibiotic Resistance Rates in Bloodstream Infections Followed in the Intensive Care Unit

Aim:The aim of this study was to evaluate the distribution of pathogens, antibiotic resistance rates, and factors affecting mortality in patients with healthcare-associated bloodstream infections (BSIs) followed in a tertiary intensive care unit (ICU). Study Design:This was a retrospective cohort study.Demographic data, comorbidities, 28day mortality, identified pathogens, and susceptibility patterns related to BSIs were retrospectively collected from patient files and hospital records.Results: A total 221 patients diagnosed with BSI were included in the study.Of these, 62.9% were male, and the median age was 70 years (interquartile range [IQR]: 59-76).The median ICU stay was 18 days (IQR: 8-29), and the median overall hospitalization was 25 days (IQR: 14-39).Gram-negative microorganisms were identified in 132 patients (59.7%), gram-positive in 74 (33.5%), and Candida spp. in 15 (6.8%).Among the gram-negative pathogens, Acinetobacter spp.[24/25 (96%)] and Klebsiella spp.[42/48 (87.5%)] exhibited the highest rates of carbapenem resistance.Vancomycin resistance was detected in two (4.8%) cases of Enterococcus spp.All-cause 28-day mortality was observed in 54 patients (24.4%).In multivariate regression analysis, only the presence of sepsis was found to be an independent predictor of mortality (odds ratio: 5.492, 95% confidence interval: 1. 836-16.424,p=0.002). Conclusions:In this study, gram-negative pathogens were the most frequently detected organisms in patients with healthcare-associated BSIs.Carbapenem resistance rates were high among gram-negative pathogens.The presence of sepsis was identified as an independent predictor of mortality in patients diagnosed with BSI.