Observational studyCritical care medicine2021
Unexpectedly High Frequency of Enterococcal Bloodstream Infections in Coronavirus Disease 2019 Patients Admitted to an Italian ICU: An Observational Study.
Observational study in Critical care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 4 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- Global Burden of Bloodstream Infections in COVID-19: Prevalence, Antimicrobial Resistance, and Mortality Risk.Viruses · 2025Pooled it
- Risk factors for bloodstream infection in COVID-19 patients in intensive care units: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Antimicrobial resistance in patients with COVID-19: a systematic review and meta-analysis.The Lancet. Microbe · 2023Pooled it
- Coronavirus Disease 2019 as Cause of Viral Sepsis: A Systematic Review and Meta-Analysis.Critical care medicine · 2021Pooled it
- Incidence and Outcomes of Bloodstream Infections in Critically Ill Patients with COVID-19: A Nationwide Multicenter Study in South Korea.Yonsei medical journal · 2026Observational
- Article
- Changes in the microbial spectrum and antimicrobial resistance of bloodstream infections in intensive care units before and during the COVID-19 pandemic.BMC infectious diseases · 2026Article
- Impact of the COVID-19 Pandemic on CLABSI Rates and Antibiotic Resistance: A Multicenter Study in Türkiye.Infectious diseases & clinical microbiology · 2025Article
- Vancomycin-Resistant Enterococci: Screening Efficacy and the Risk of Bloodstream Infections in a Specialized Healthcare Setting.Antibiotics (Basel, Switzerland) · 2025Article
- Impact of the COVID-19 pandemic on vancomycin-resistantFrontiers in microbiology · 2025Article
- Increased risk of Enterococcal Bacteremia in critically ill patients with COVID-19 during pandemic surges.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Impact of Needle-Free Connector and Prefilled Flushing Syringe Shortage on CLABSI Rates in Pediatric Intensive Care.Infectious diseases & clinical microbiology · 2024Article
- Bloodstream infections in the era of the COVID-19 pandemic: Changing epidemiology of antimicrobial resistance in the intensive care unit.Journal of intensive medicine · 2024Review
- Characteristics of Enterococcus species bloodstream infections among adults with and without onco-hematological malignancies: Experiences from the national center of Hungary.European journal of microbiology & immunology · 2024Article
- Changes in clinical parameters and inflammatory markers after blood culture collection facilitate early identification of positive culture in adult patients with COVID-19 and clinically suspected bloodstream infection.The Journal of international medical research · 2024Article
- Corticosteroid Dosing Level, Incidence and Profile of Bacterial Blood Stream Infections in Hospitalized COVID-19 Patients.Viruses · 2024Article
- Review
- The impact of the COVID-19 pandemic on blood culture practices and bloodstream infections.Microbiology spectrum · 2023Article
- Blood Stream Infections in COVID-19 Patients From a Tertiary Care Center in Lebanon: Causative Pathogens and Rates of Multi-Drug Resistant Organisms.Mayo Clinic proceedings. Innovations, quality & outcomes · 2023Article
- Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review.Infection prevention in practice · 2023Review
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aimed to assess the frequency of ICU-acquired bloodstream infections in coronavirus disease 2019 patients.
designRetrospective observational study.
settingThe emergency expansion of an ICU from eight general beds to 30 coronavirus disease 2019 beds.
participantsPatients with coronavirus disease 2019 admitted to the ICU of Luigi Sacco Hospital (Milan, Italy) for greater than or equal to 48 hours between February 21, 2020, and April 30, 2020.
interventionsNone. MEASUREMENTS AND MAIN
resultsThe frequency of bloodstream infections per 1,000 days of ICU stay was calculated in 89 coronavirus disease 2019 patients, and the cumulative probability of bloodstream infection was estimated using death and ICU discharge as competing events. Sixty patients (67.4%) experienced at least one of the 93 recorded episodes of bloodstream infection, a frequency of 87 per 1,000 days of ICU stay (95% CI, 67-112).The patients who experienced a bloodstream infection had a higher Sequential Organ Failure Assessment score upon ICU admission (9.5; interquartile range, 8-12 vs 8, interquartile range, 5-10; p = 0.042), a longer median ICU stay (15 d; interquartile range, 11-23 vs 8, interquartile range, 5-12; p < 0.001), and more frequently required invasive mechanical ventilation (98.3% vs 82.8%; p = 0.013) than those who did not. The median time from ICU admission to the first bloodstream infection episode was 10 days. Gram-positive bacteria accounted for 74 episodes (79.6%), with Enterococcus species being the most prevalent (53 episodes, 55.8%). Thirty-two isolates (27.3%) showed multidrug resistance.
conclusionsCoronavirus disease 2019 seemed to increase the frequency of bloodstream infections (particularly Enterococcus-related bloodstream infection) after ICU admission. This may have been due to enteric involvement in patients with severe coronavirus disease 2019 and/or limitations in controlling the patient-to-patient transmission of infectious agents in extremely challenging circumstances.
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