Infection and drug resistance
Fungal Versus Gram-Negative Bloodstream Infection and 30-Day Mortality in Critically Ill Patients: A Propensity Score-Matched MIMIC-IV Analysis with an Allo-HSCT Comparison Cohort
By Shao H, Zhu Q, Ju L and 2 others.
Abstract
Background
Fungal bloodstream infections (BSIs) are linked to substantial morbidity and mortality among critically ill patients; however, comparative analyses with Gram-negative BSIs remain scarce.
Methods
In this retrospective MIMIC-IV v3.1 study, adults were included if their first bloodstream infection (BSI) occurred during an ICU stay. The primary propensity score model included age, sex, Sequential Organ Failure Assessment score within 24 hours of ICU admission (SOFA_24hours), Simplified Acute Physiology Score II (SAPS II), Charlson comorbidity index, and immunosuppressive therapy within 30 days before the index culture. Patients were matched 1:1 using a 0.2-SD logit caliper. Inverse probability of treatment weighting (IPTW), doubly robust, extended-window, and SOFA_24hours ≥2 analyses were performed. The primary endpoint was 30-day all-cause mortality. An independent allogeneic hematopoietic stem cell transplantation (allo-HSCT) comparison cohort was also analyzed.