Few data are presently available on Gram-negative bacilli septic thrombosis (GN-ST) in intensive care unit (ICU) patients.
Retrospective case-control study (matched 1:3) performed on ICU patients with bacteremia associated (cases) or not (controls) to GN-ST over a 15-month period aimed to assess 30-day mortality and clinical/microbiological features of GN-ST.
During study period 16 patients with GN-ST and 48 controls were analyzed. Polytrauma was the cause of ICU admission in 12 (75%) cases and 22 (46%) controls (p = 0.019). In no case of ST was performed a surgical debridement; the site of venous thrombosis was more frequently in lower limbs associated with bone fracture in 9 out of 12 (75%) cases. Median duration of bacteremia (22 vs 1 days, p < 0.001) and time to clinical improvement (15 vs 4 days, p < 0.001) were significantly longer in cases. At ROC curve, a bacteremia >72 hours was significantly associated with GN-ST (AUC 0.95, sensitivity 0.996 and specificity 0.810, p < 0.001). Finally, 30-day mortality was 20% in cases and 67% among controls (p < 0.001).
Critically ill patients with GN-ST showed specific clinical features. Despite delayed bacteremia clearance, targeted antibiotic therapy plus anticoagulation usually provide clinical improvement and a low 30-day mortality rate.

Copyright © 2020. Published by Elsevier Ltd.

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