Although, several studies have examined the epidemiology and the prognostic utility of ICU-BSI, a useful addition to this literature would be the assessment of concordance between the pathogens isolated from ICU-BSI and those isolated from clinical site sampling that define HCAI. The common clinical site foci for secondary ICU-BSI are the respiratory, gastrointestinal and urinary tracts -,. ICU-BSI can either occur secondary to the dissemination of pathogens from a primary focus of infection at a clinical site into the bloodstream, or can be primary where the source of infection is unclear. Similar to other HCAIs in an ICU setting, ICU-BSIs are common and patients who develop ICU-BSIs are at higher risk of adverse outcomes. HCAI bloodstream infections in an ICU setting (ICU-BSIs) refer to the detection of pathogenic organisms in blood culture 48 h or more following ICU admission. HCAIs are often associated with indwelling devices and/or breach of natural barrier defence mechanisms and thus are potentially preventable with modifications in practice. Healthcare-associated infections (HCAIs) are common in patients managed in a critical care setting (ICU). ConclusionsĬlinical practice should focus on a) improving blood culture techniques to reduce detection of contaminant pathogens and b) ensuring paired clinical site cultures are performed alongside all blood cultures to better understand the epidemiology and potential implications of primary and secondary discordant health-care associated bloodstream infections. Excluding contaminants and central venous line infections, in only 39.5% of the bloodstream infections could a concordant clinical site source be identified, the respiratory and urinary tracts being the most common. Central venous catheter-linked bloodstream infections represent only 6.0% of the positive blood cultures. The most common non-contaminant pathogens cultured were Pseudomonas spp.

ResultsĬontaminant pathogens accounted for half of the isolates. Pathogens detected and concordances with clinical site are reported as proportions. All nosocomial positive blood cultures over a 4-year study period were identified. We conducted a descriptive cross-sectional study in critically ill adults admitted to a tertiary semi-closed intensive care unit in England to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates. The objectives of the study were to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates. An in-depth understanding of their epidemiology is essential to reduce occurrence and to improve outcomes by targeted prevention strategies. Healthcare-associated bloodstream infections are related to both increased antibiotic use and risk of adverse outcomes.

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