[Bloodstream infections in adult patients of two tertiary care centers of Córdoba, Argentina].

INTRODUCTION

Bloodstream infections (BSI) are a significant cause of hospital morbidity and mortality. The main objective was to determine the characteristics of community-acquired BSI (CA-BSI) and hospital-acquired BSI (IH-BSI) in two tertiary care hospitals.

MATERIALS AND

METHODS

A retrospective study was conducted on true bacteremia episodes recorded between January 2020 and February 2021 in two tertiarylevel hospitals in Córdoba, Argentina. Patients aged ≥18 years, non-pregnant, were included. Clinical features, microbiological profiles, and 30-day mortality were analyzed.

RESULTS

A total of 403 BSI episodes were identified, with 438 microbial isolates; 32 (7.9%) were polymicrobial. Hospital-acquired BSI (HA-BSI) accounted for 209 cases (51.9%). The median patient age was 66 years (IQR 56-75), and 247 (61.3%) were male. Primary bacteremia was the most frequent source (116/403, 28.8%), more common in HA-BSI (79/209, 37.8%) than in community-acquired BSI (CA-BSI) (37/194, 19.1%; p<0.05). Urinary tract infections were the second most frequent source (84/403, 20.8%), predominantly in CA-BSI (67/194, 34.5% vs. 17/209, 8.1%; p<0.05). Gram-negative bacilli accounted for 301/438 isolates (68.7%), with Escherichia coli being most frequent (125/438, 28.5%). Multidrug-resistant organisms (MDRO) were isolated in 155 cases (38.5%), more often in HA-BSI (109/209, 52.2% vs. 46/194, 23.7%; p<0.05). Thirty-day mortality was 26.3% (106/403), higher in HA-BSI (76/209, 36.4% vs. 30/194, 15.5%; p<0.05), respiratory-source infections (17/106, 16% vs. 15/297, 5.1%; p<0.05), and recent COVID-19 cases (40/106, 37.7% vs. 41/297, 13.9%; p<0.05).

CONCLUSION

Most BSI episodes were hospital-acquired, with a high prevalence of MDRO and 30-day mortality. Continuous local surveillance is essential to inform evidence-based treatment protocols.