{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:40:43Z","timestamp":1792100443151,"version":"4.4.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of polymicrobial bloodstream infections in critically ill patients is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational cohort study included patients admitted to the ICU for \u22653d. We compared patients with monomicrobial versus polymicrobial (ie, \u22651 positive blood culture with \u22652 isolates) bloodstream infections. Inverse-probability weighting and covariate-adjusted generalized linear regression models were used to calculate adjusted differences in risks and means. The primary outcome was 90-day all-cause mortality from index culture. Secondary outcomes included 30-day all-cause mortality, microbiological failure, ECMO at 30 days, ARDS at 7 days, fever at 7 days, length of ICU and hospital stay. A separate analysis was performed excluding common skin commensals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 03\/2014 and 03\/2024, 3197 patients were included in the overall and 1669 in the common commensal-free cohort. In the overall cohort, 90-day mortality occurred in 749 (28.3%, adjusted 28.3%) of 2648 patients in the monomicrobial group and 164 (29.9%, adjusted 31.1%) of 549 patients in the polymicrobial group (adjusted risk difference, 2.84% [95%CI, \u22121.19\u20136.88]). All-cause 30-day mortality, microbiological failure (adjusted, 4.67% vs 6.56%), initiation of ECMO (adjusted, 3.65% vs 2.99%), ARDS (adjusted, 17.4% vs 15.7%), fever (adjusted, 19.1% vs 20.4%), length of ICU stay (adjusted means, 19.6 vs 19.8 days), and length of hospital stay (adjusted means, 42.6 vs 45.2 days) did not differ significantly between the groups. Outcomes did not differ in the common commensal-free cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical and microbiological outcomes were comparable between critically ill patients with monomicrobial and polymicrobial bloodstream infections, regardless of whether suspected contaminants were excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf591","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T11:53:17Z","timestamp":1758369197000},"source":"Crossref","is-referenced-by-count":2,"title":["Clinical and Microbiological Outcomes of Critically Ill Patients With Monomicrobial Versus Polymicrobial Bacterial Bloodstream Infections: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-5878","authenticated-orcid":false,"given":"Anselm","family":"Jorda","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-9036","authenticated-orcid":false,"given":"Felix","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-8310","authenticated-orcid":false,"given":"Marlene","family":"Prager","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Kumpf","sequence":"additional","affiliation":[{"name":"IT Systems and Communications, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gelbenegger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zeitlinger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"2025102314052150100_ofaf591-B1","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1001\/jama.2009.1754","article-title":"International study of the prevalence and outcomes of infection in intensive care units","volume":"302","author":"Vincent","year":"2009","journal-title":"JAMA"},{"key":"2025102314052150100_ofaf591-B2","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.amjmed.2010.03.021","article-title":"The clinical and prognostic importance of positive blood cultures in adults","volume":"123","author":"Pien","year":"2010","journal-title":"Am J Med"},{"key":"2025102314052150100_ofaf591-B3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jgar.2013.06.005","article-title":"Polymicrobial bloodstream infections: epidemiology and impact on mortality","volume":"1","author":"Pavlaki","year":"2013","journal-title":"J Glob Antimicrob Resist"},{"key":"2025102314052150100_ofaf591-B4","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1007\/s00134-012-2695-9","article-title":"Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: the EUROBACT International Cohort Study","volume":"38","author":"Tabah","year":"2012","journal-title":"Intensive Care Med"},{"key":"2025102314052150100_ofaf591-B5","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1186\/s12879-024-09130-5","article-title":"Polymicrobial bloodstream infections per se do not increase mortality compared to monomicrobial bloodstream infections in sepsis patients: a Korean nationwide sepsis cohort study","volume":"24","author":"Lee","year":"2024","journal-title":"BMC Infect Dis"},{"key":"2025102314052150100_ofaf591-B6","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.ajic.2016.02.017","article-title":"Comparison of clinical outcomes and risk factors in polymicrobial versus monomicrobial enterococcal bloodstream infections","volume":"44","author":"Lagnf","year":"2016","journal-title":"Am J Infect Control"},{"key":"2025102314052150100_ofaf591-B7","doi-asserted-by":"crossref","first-page":"e0185768","DOI":"10.1371\/journal.pone.0185768","article-title":"A fresh look at polymicrobial bloodstream infection in cancer patients","volume":"12","author":"Royo-Cebrecos","year":"2017","journal-title":"PLoS One"},{"key":"2025102314052150100_ofaf591-B8","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.diagmicrobio.2009.02.008","article-title":"Factors associated with mortality in bacteremic patients with hematologic malignancies","volume":"64","author":"Tumbarello","year":"2009","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2025102314052150100_ofaf591-B9","author":"Centers for Disease Control and Prevention (CDC)"},{"key":"2025102314052150100_ofaf591-B10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin Microbiol Infect"},{"key":"2025102314052150100_ofaf591-B11","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin definition","volume":"307","author":"ARDS Definition Task Force","year":"2012","journal-title":"JAMA"},{"key":"2025102314052150100_ofaf591-B12","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cmi.2024.10.026","article-title":"Real-world effectiveness of nirmatrelvir-ritonavir and molnupiravir in non-hospitalized adults with COVID-19: a population-based, retrospective cohort study","volume":"31","author":"Jorda","year":"2025","journal-title":"Clin Microbiol Infect"},{"key":"2025102314052150100_ofaf591-B13","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/bimj.200810488","article-title":"Some methods of propensity-score matching had superior performance to others: results of an empirical investigation and Monte Carlo simulations","volume":"51","author":"Austin","year":"2009","journal-title":"Biom J"},{"key":"2025102314052150100_ofaf591-B14","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jclinepi.2005.12.009","article-title":"Case mortality in polymicrobial bloodstream infections","volume":"59","author":"McKenzie","year":"2006","journal-title":"J Clin Epidemiol"},{"key":"2025102314052150100_ofaf591-B15","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/j.1553-2712.2010.00871.x","article-title":"Characteristics and outcomes of polymicrobial bloodstream infections in the emergency department: a matched case-control study","volume":"17","author":"Lin","year":"2010","journal-title":"Acad Emerg Med"},{"key":"2025102314052150100_ofaf591-B16","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1007\/s10096-011-1503-8","article-title":"Impact of nosocomial polymicrobial bloodstream infections on the outcome in critically ill patients","volume":"31","author":"Sancho","year":"2012","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2025102314052150100_ofaf591-B17","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.ijantimicag.2019.09.015","article-title":"Clinical predictors and outcome impact of community-onset polymicrobial bloodstream infection","volume":"54","author":"Yo","year":"2019","journal-title":"Int J Antimicrob Agents"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofaf591\/64374757\/ofaf591.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/10\/ofaf591\/64374757\/ofaf591.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/10\/ofaf591\/64374757\/ofaf591.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T18:05:28Z","timestamp":1761242728000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaf591\/8263036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,9,29]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaf591","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,9,24]]},"article-number":"ofaf591"}}