The incidence and outcomes of hospital acquired- bloodstream infection and ventilator associated pneumonia and the impact of infectious diseases referral using data from the clinically-oriented antimicrobial resistance surveillance network for healthcare-associated infections (ACORN-HAI): An interim report.

Objectives: To determine the incidence of hospital-acquired bloodstream infections (BSI), Ventilator-Associated Pneumonias (VAP) and the impact of Infectious Diseases (ID) referral on outcomes using data from the ACORN HAI surveillance network. Methods: Adults hospitalized ≥48 h in a tertiary hospital (3/2023-3/2024) were prospectively included if HA-BSI and VAP criteria were met. ID referral was defined as formal referral to, or consultation with an ID specialist. Clinical, laboratory parameters, and 28-day outcomes were collected. The incidence of HA-BSI and VAP was calculated using the number of patients with HA-BSI or VAP as numerator, and total hospitalized adult patients as denominator; incidence density per 1000 patient-days was computed using infection episodes as numerator, and total patient-days as denominator. Results: Among 115 patients (mean age 62.4 ± 18.1 years), 58.3% were male, and 33. 91% diabetic. HA-BSI incidence density was higher compared to VAP (1.03 vs. 46 per 1000 patient-days). Mortality (BSI 24.7%, VAP 50%, combined infection 57.1%) differed across infection types. Majority of infection episodes were referred to ID (119/143, 83.21%). Although late referrals (9/143, 6.29%), had numerically higher mortality and prolonged hospitalization, these were not statistically significant. The timing of ID referral had no statistically significant association with clinical and functional outcomes, mortality, and length of stay. Conclusion: Overall HA-BSI and VAP rates were low, but still associated with high mortality and prolonged hospitalization. ID referral was not associated with better outcomes in this small study.