Tabah, Alexis, Edwards, Felicity, Ramanan, Mahesh, White, Kyle C., Shekar, Kiran, McIlroy, Philippa, Attokaran, Antony, Senthuran, Siva, Mccullough, James, Kumar, Aashish, Luke, Stephen, Bhadange, Neeraj, Garrett, Peter, and Laupland, Kevin B. (2024) Intensive care unit–onset bloodstream infections represent a distinct category of hospital–onset infections: A multicentre, retrospective cohort study. Queensland Critical Care Network (QCCRN). Journal of the Association of Medical Microbiology and Infectious Disease Canada, 9 (4). pp. 229-238.

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Abstract

Background: The location of onset of bloodstream infections (BSIs) associated with intensive care unit (ICU) admission may influence their clinical and epidemiological characteristics. Methods: A multicentre, retrospective cohort study was conducted in Queensland, Australia, and BSIs associated with ICU admission were identified and classified as community-onset, hospital-onset, or ICU-onset if first isolated within, after 48 hours but within 48 hours of ICU admission, or after 48 hours following ICU admission, respectively. Results: We included 3,540 episodes of ICU-associated BSI, with 1,693 classified as community-onset, 663 hospital-onset, and 1,184 ICU-onset. Compared with hospital-onset BSIs, patients with ICU-onset BSIs were younger, had fewer comorbidities, had lower APACHE II scores, and were more likely male. Patients with ICU-onset BSI were more likely to be surgical admissions and have a primary cardiovascular or neurological diagnosis. The distribution of infective agents varied significantly among community-, hospital-, and ICU-onset BSI groups. The all-cause 30-day case-fatality rates for first-episode community-onset, hospital-onset, and ICU-onset BSIs were 17.1%, 21.7%, and 23.5%, respectively (p < 0.001). Conclusion: With different epidemiological features and causal pathogens, ICU-onset BSI represents a distinct BSI group arising in hospitalized patients.

Item ID:	85139
Item Type:	Article (Research - C1)
ISSN:	2371-0888
Copyright Information:	© Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada), 2024. This article is free to read to all interested readers, immediately upon publication. For their own personal use, users may read, download, print, search, or link to the full text. Manuscripts published in the Journal of the Association of Medical Microbiology and Infectious Disease Canada are copyrighted to the Association of Medical Microbiology and Infectious Disease Canada.
Date Deposited:	17 Dec 2025 00:07
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3207 Medical microbiology > 320799 Medical microbiology not elsewhere classified @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 100%
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