# P-40. Characterization of ICU-Acquired Bloodstream Infections in a High-Complexity Institution in Bogotá, Colombia since 2017-2024

## TL;DR

This study examines how ICU-acquired bloodstream infections changed from 2017 to 2024 in Colombia, showing increased rates during the pandemic and rising antibiotic resistance.

## Contribution

The study provides a detailed analysis of ICU-acquired bloodstream infections across prepandemic, pandemic, and postpandemic periods in a high-complexity hospital.

## Key findings

- ICU-acquired bloodstream infection incidence increased during the pandemic (1.08%) compared to prepandemic (0.72%) and postpandemic (0.64%) periods.
- Carbapenem-resistant organisms increased in prevalence post-pandemic (from 6.8% to 13.6%).
- Catheter-associated infections were most common during the pandemic, caused mainly by methicillin-resistant gram-positive cocci.

## Abstract

Objective To analyze the evolution of the incidence, etiology, and antimicrobial resistance of intensive care unit (ICU)-acquired blood stream infections (BSIs) during the prepandemic, pandemic, and postpandemic periods (2017–2024), evaluating their impact on in-hospital mortality.Figure 1:Pathogens by Source of Bloodstream InfectionTable 1:Characteristics of bloodstream infection

Pathogens by Source of Bloodstream Infection

Characteristics of bloodstream infection

A retrospective observational study was conducted, including 226 patients over 18 years old with (ICU)-acquired BSI from Clínica Universitaria Colombia. Demographic, clinical, microbiological, and mortality variables were analyzed. Univariate and bivariate statistical analyses were used to identify significant differences.Table 2:Antimicrobial Resistance profile of identified pathogens

Antimicrobial Resistance profile of identified pathogens

During the SARS-CoV-2 pandemic, the incidence of ICU-acquired infections increased to 1.08%, compared to the prepandemic period 0.72% and postpandemic period 0.64%. Catheter-associated bloodstream infections were the most prevalent during the pandemic period, predominantly caused by methicillin-resistant gram-positive cocci. An increasing trend in the prevalence of carbapenem-resistant organisms was observed in the post-pandemic period (from 6.8% to 13.6%) compared to previous periods. No significant differences were observed in the overall mortality of patients with ICU-acquired BSIs across the periods. An increase in the consumption of antibiotics against methicillin-resistant gram-positive cocci and ceftazidimeavibactam was observed.

The findings demonstrate an increased incidence of ICU-acquired BSIs during the pandemic, along with a rise in carbapenem resistance in the post-pandemic period. These results highlights the need to adjust empirical antimicrobial strategies, reinforce antimicrobial stewardship programs, and enhance infection control measures in critical care setting.

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