Gut barrier dysfunction and the risk of ICU-acquired bacteremia- a case–control study
Authors' conclusion
We could not demonstrate an association between biomarkers of gastrointestinal barrier dysfunction and an increased occurrence of bacteremia due to gut compared to skin flora during critical illness, suggesting against bacterial translocation as a major vector for acquisition of nosocomial bloodstream infections in the ICU.
Study context
- Population
- Patients in two mixed medical-surgical tertiary ICUs in the Netherlands, enrolled 2011–2018
- Participants
- 72 vs 137
- Comparison
- ICU-acquired enterococcal bacteremia vs coagulase-negative staphylococci (CoNS) bacteremia
- Casesn = 72
- Controlsn = 137reference
- Outcome
- Composite Gut Barrier Injury (GBI):
- Sum of standardized z-scores of intestinal fatty acid-binding protein
- Trefoil factor-3
- Citrulline plus a clinical gastrointestinal failure score
- Follow-up
- 48 h before bacteremia onset
Methodological detailsmatched controls, two-centre
- Matched controls
- Two-centre
Main finding
As reported in the abstract
Composite Gut Barrier Injury (GBI) score
Cases
0.58
median · IQR - 0.36-1.69
Controls
0.32
median · IQR - 0.53-1.57
P = 0.33
- Higher composite Gut Barrier Injury (GBI) and occurrence of enterococcal vs CoNS bacteremia, multivariable analysis
- 1.12 (aOR; 95% CI 0.93-1.34; p = 0.22; not significant)
Observational data: associations, not effects.
Further findings
Single biomarkers
- No single biomarker yielded statistically significant differences between cases and controls
Composite GBI vs disease severity and ICU mortality
- Higher composite GBI correlated with higher disease severity and ICU mortality
- P < 0.001
Original publication
Gut barrier dysfunction and the risk of ICU-acquired bacteremia- a case–control study. Ann Intensive Care. Published 27 March 2024. doi:10.
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