Bloodstream infection in the Intensive Care Unit: clinical outcomes, microbiological profile, and economic impact

Abstract

Objective: To evaluate the clinical and economic outcomes of patients with bloodstream infections in ICUs of a tertiary hospital in Ceará, Brazil. Methods: A descriptive and cross-sectional study (January to December 2024) with a quantitative-qualitative approach. Clinical, microbiological, and pharmaceutical data from institutional systems and the Hospital Infection Control Service were analyzed. The economic analysis focused on direct costs of antimicrobials and ICU stays. Results: Ninety infections were analyzed, with a prevalence in elderly patients (61–80 years; 56%) and high mortality (58.9%). The most frequent pathogens were Klebsiella pneumoniae and Candida spp. High bacterial resistance was observed, including MRSA, VRE, and Gram-negative bacteria producing carbapenemases and ESBLs. Economically, the average cost of antimicrobials was R$ 1,090.98, with 55.5% of patients experiencing an increase in prescription costs after the infection diagnosis. Conclusion: Healthcare-associated infections (HAIs) in ICUs present high mortality rates, a strong presence of multidrug-resistant microorganisms, and a significant financial impact. The results reinforce the need for rigorous microbiological surveillance, multidisciplinary action, and strengthening of stewardship programs.