Category: COVID-19 Complications, Co-infections, and Clinical Outcomes

Poster Session: COVID-19 Complications, Co-infections, and Clinical Outcomes

407 - Utilization of Blood Cultures, Risk factors and Outcomes of Bloodstream Infections in Patients Hospitalized with COVID-19

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Presenting Author(s)

Smitha Gudipati

Infectious Disease Faculty
Henry Ford Health System
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

Amit T. Vahia

Doctor
Ascension St. John Hospital
LIVONIA, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NP

Nicole Pahl

Infection Preventionist
Henry Ford Hospital
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Indira Brar

Associate Clinical Professor Wayne State School of Medicine
Henry Ford Hospital
Detroit, Michigan
Disclosure: Gilead (Speaker's Bureau)janssen (Speaker's Bureau)ViiV (Speaker's Bureau)
GS

Geehan Suleyman

Medical Director, Infection Prevention
Henry Ford Health
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SA

Samia Arshad

Epidemiologist II
Henry Ford Health System
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MZ

Marcus Zervos

Division Head of Infectious Diseases
Henry Ford Hospital
Detroit, Michigan
Disclosure: Melinta Therapeutics (Grant/Research Support)
GA

George J. Alangaden

Associate Clinical Professor Wayne State School of Medicine
Henry Ford Hospital
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: During the coronavirus disease 2019 (COVID-19) surge, there was a sharp increase of blood cultures (BC) performed at Henry Ford Health System (HFHS). However, the epidemiology and outcomes of bloodstream infections (BSI) in COVID-19 patients (pts) remains undefined. We report the utilization of blood cultures, risk factors and mortality associated with BSI in a large cohort of COVID-19 pts.

Methods: A retrospective analysis was performed of all COVID-19 pts that had BC performed during hospitalization at HFHS, a 5-hospital system in southeast Michigan. BSI was defined using NHSN criteria. Demographics, comorbidities, severity of illness, and outcome of pts with and without BSI were compared.

Results: From 3/10/2020 to 4/28/2020, 2541 pts were hospitalized with lab-confirmed COVID-19. 1393 (55%) of these pts had BC performed and 80 (5.74%) met criteria for BSI. Of the 84 pathogens identified, Staphylococcus aureus was most common (Figure 1). As compared to 1313 COVID-19 pts without BSI, those with BSI were older (70.1 vs 64.5 years, P = 0.0024). Other factors significantly associated with BSI included chronic kidney disease, higher mSOFA score, ICU stay and mechanical ventilation (all P < 0.0001) (Table 1). Multivariate analysis revealed age (OR, 1.07 CI [1.06-1.08]), ICU stay (OR, 7.91 [CI: 5.75-10.87]) and mSOFA score (OR, 1.29 [CI: 1.13-1.47]) were independent risk factors associated with mortality. BSI was not associated with increased mortality (Table 3).

Table 1. Characteristics of COVID-19 patients with BSI compared to COVID-19 patients without BSI

Table 2. Odds of Mortality Univariate and Multivariate Analysis

Figure 1. Cumulative Number of Bloodstream Pathogens in COVID-19 Patients

Conclusion: Although more than half of hospitalized COVID-19 pts had BC done, the number of BSI were low suggesting overutilization of BC. BSI was associated with older age and disease severity. Mortality was not affected by BSI but was primarily driven by age and severity of illness.