Background Correlation between COVID-19 and superinfections has been investigated, but remains to be fully assessed. In this multicenter study we report the impact of the pandemic on bloodstream infections. Methods This study includes all patients with a BSI admitted to four Italian hospitals between January 1st and June 30th, 2020. Clinical, demographic, and microbiologic data were compared with those of patients hospitalized during the same period of 2019. Results Among 26,012 patients admitted in the first semester of 2020, 1,182 had COVID-19. In patients with COVID-19, we observed 107 BSIs, with an incidence rate of 8.19 episodes per 1000 patient-days. This incidence was significantly higher than in patients without COVID-19 (2.72/1000 patient-days) and in patients admitted in 2019 (2.76/1000 patient-days). In comparison with patients without COVID-19, BSIs onset in patients with COVID-19 was delayed during the course of hospitalization (16.0 vs 5 days). Thirty-day mortality among patients with COVID-19 was 40.2%, significantly higher than in patients without COVID-19 (23.7%). BSIs in patients with COVID-19 were frequently caused by MDR pathogens, which were often center-dependent. Conclusions BSIs are a frequent secondary infection in patients with COVID-19, characterized by an increased risk during hospitalization and potentially burdened with high mortality.
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