427. Bloodstream infections among adult COVID-19 patients in Colombian hospitals between 2020-2021
Authors: Pallares Christian , Villegas María Virginia , Porras Jessica , Ordoñez Karen Melissa , Vente Elsa Yasmín , Patiño Erika Vanessa , Gómez Sandra Milena 
Published: November 2023

Abstract

Background
Coronavirus is one of the major pathogens that primarily targets the human respiratory system. In COVID-19 patient’s, bloodstream infections (BSI) have not been extensively studied in Latin-America. Given the impact of COVID-19 pandemic in Colombia and the high rate of hospitalizations, information about risk factors and ways to prevent BSI among COVID-19 patients is urgently needed. This investigation aimed to identify risk factors in BSI in hospitalized patients with COVID-19.

Methods
A case-control design was used; cases were patients with a PCR confirmed COVID-19 infection and BSI. Controls were patients with a PCR confirmed COVID-19 who did not have a BSI during their hospitalization. Information about demographic, clinical characteristics, comorbidities and exposures that could be related to BSI were reviewed. Descriptive statistics were calculated, odds ratios (ORs) and 95% confidence intervals were estimated using multivariable conditional logistic regression models. In accordance with Colombian regulations -Resolution 8430 of the Ministry of Health of 1993- this project was classified as risk-free.

Results
306 patients (153 cases and 153 controls) from four participating hospitals were included. Cases and controls had similar average age (62-63 years), median length of stay (19-25 days), comorbidities and similar Newscore scale regarding severity on admission to the hospital; all cases and 89% of controls required at least one invasive device. Cases were more likely to have required an orotracheal tube (97% vs. 81%; p&lt; 0.05), central venous catheter (95% vs. 82%; p&lt; 0.05), or urinary catheter (98% vs. 80%; p&lt; 0.05) compared with controls. Cases had higher previous antimicrobials use (91% vs. 77%; p&lt; 0.05), pronation (93% vs. 81%; p&lt; 0.05) and chlorhexidine bath (58% vs. 83%, p&lt; 0.05) than controls. However,no statistically significant differences in mortality between cases and controls was found. In the multivariate analysis, urinary catheter used (OR= 11.05; IC95% 1.18–103.18) was a risk factor and chlorhexidine bath (OR=0.47; IC95% 0.25–0.88) was a protective factor for BSI.
CASE AND CONTROL CHARACTERISTICS
BIVARIATE AND MULTIVARIATE ANALYSIS

Conclusion
COVID-19 patients are more propense to BSI, but bathing with chlorhexidine and care and monitoring of invasive devices are modifiable factors to minimize the risk of infections.

Disclosures
Christian Pallares, MD, MSc, 3M: Advisor/Consultant|3M: Honoraria|MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Westquímica: Advisor/Consultant|Westquímica: Grant/Research Support|Westquímica: Honoraria María Virginia Villegas, n/a, MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Westquímica: Advisor/Consultant|Westquímica: Grant/Research Support|Westquímica: Honoraria Karen Melissa Ordoñez, n/a, Pfizer: Advisor/Consultant|Pfizer: Honoraria