ArticleCritical care (London, England)2026
ICU-acquired infection in neutropenic patients.
Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAmong neutropenic patients, sepsis is a frequent cause of ICU admission, and its epidemiology is well described, but data on infection acquired during the ICU stay (ICU-AI) are lacking.
aimWe aim to describe, using a large nationwide cohort study, the incidence of ICU-AI for neutropenic patients in a large network of French intensive care units (ICUs).
methodsThis study was conducted using the healthcare-associated infection surveillance cohort “REA-REZO” involving 265 participating ICUs. All patients admitted to a participating ICU from 1st January 2018 to 31th December 2023, for more than 48 h were eligible. The primary endpoint was the rate of ICU-AI. A matched analysis was conducted using non-parsimonious regression model to compare neutropenic and non-neutropenic patients.
findingsMatching process resulted in well-balanced 7545 patients’ pairs. ICU-AI incidence rate was 14.9 versus 13.0 AI per 1000 patients days in the neutropenic group vs non-neutropenic group (Incidence Rate Ratio [IRR] = 1.15 [1.05, 1.25] p = 0.002) with higher incidence rate for bloodstream infection (BSI) (p < 0.001) but comparable incidences rates of pneumonia (p = 0.503) and central-line associated BSI (p = 0.100). There were less enterobacterales among ICU-AI of the neutropenic group (33.8% vs 45.4%, p < 0.001), but higher rate of coagulase negative Staphylococcus (12.0% vs 5.2%, p < 0.001), Enterococcus spp, (8.9% vs 6.0%, p = 0.015) and Candida spp. (10.4% vs 6.2%, p = 0.001). Rates of ICU-AI involving multidrug resistant micro-organisms did not differed, neither did the rate of ICU-AI involving non fermenting Gram-negative bacilli.
conclusionNeutropenic patients had higher ICU-AI incidence as compared with non-neutropenic patients, specifically through an increase of BSI incidence. Microbiology differs between neutropenic patients and non-neutropenic patients with no difference in multidrug resistant microorganism involvement.
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