{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:27:28Z","timestamp":1791678448096,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about the incidence and risk of intensive care unit (ICU)\u2010acquired bloodstream infections (BSI) in critically ill patients with coronavirus disease 2019 (COVID\u201019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This retrospective, single\u2010centre study was conducted in Northern Italy. The primary study objectives were as follows: (a) to assess the incidence rate of ICU\u2010acquired BSI and (b) to assess the cumulative risk of developing ICU\u2010acquired BSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 78 critically ill patients with COVID\u201019 were included in the study. Forty\u2010five episodes of ICU\u2010acquired BSI were registered in 31 patients, with an incidence rate of 47 episodes (95% confidence interval [CI] 35\u201063) per 1000 patient\u2010days at risk. The estimated cumulative risk of developing at least one BSI episode was of almost 25% after 15\u00a0days at risk and possibly surpassing 50% after 30\u00a0days at risk. In multivariable analysis, anti\u2010inflammatory treatment was independently associated with the development of BSI (cause\u2010specific hazard ratio [csHR] 1.07 with 95% CI 0.38\u20103.04 for tocilizumab, csHR 3.95 with 95% CI 1.20\u201013.03 for methylprednisolone and csHR 10.69 with 95% CI 2.71\u201042.17 for methylprednisolone plus tocilizumab, with no anti\u2010inflammatory treatment as the reference group; overall <jats:italic>P<\/jats:italic> for the dummy variable\u00a0=\u00a00.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence rate of BSI was high, and the cumulative risk of developing BSI increased with ICU stay. Further study will clarify if the increased risk of BSI we detected in COVID\u201019 patients treated with anti\u2010inflammatory drugs is outweighed by the benefits of reducing any possible pro\u2010inflammatory dysregulation induced by SARS\u2010CoV\u20102.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13319","type":"journal-article","created":{"date-parts":[[2020,6,14]],"date-time":"2020-06-14T11:05:35Z","timestamp":1592132735000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":237,"title":["Bloodstream infections in critically ill patients with COVID\u201019"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-1759","authenticated-orcid":false,"given":"Daniele Roberto","family":"Giacobbe","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit Ospedale Policlinico San Martino \u2013 IRCCS Genoa Italy"},{"name":"Department of Health Sciences (DISSAL) University of Genoa Genoa 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