BLOOMY-PREDICT – Bloodstream infections due to multidrug-resistant organisms

Short description

Bloodstream infections (BSI) are associated with high morbidity and mortality worldwide and are still considered as one of the most severe bacterial infections. The BLOOMY-PREDICT project is an observational study, which runs at five German university hospitals. Within the scope of the project, different clinical values of patients such as previous illnesses, certain blood values or data on the course of treatment are combined to form a so-called clinical score. With the help of this score, patient groups with a higher risk of long-term consequences can in future receive additional diagnostics, more intensive therapy schedules, increased monitoring and closer follow-up checks after discharge from hospital.

An estimated six percent of patients in acute hospitals develop nosocomial infections, with a total of 3.2 million cases per year, which in turn contribute to approximately 150,000 deaths and 16 million additional hospital days per year. The costs caused by antibiotic resistance are not limited to the medical environment or the public health sector.

Recent data showed that evaluations of the therapeutic success after severe bacterial infections, which are limited to the length of hospital stay, significantly underestimate mortality and the severe consequences for the patients' quality of life and/or deterioration of cognitive and functional abilities.

This project is based on the results of the BLOOMY.COM study. The BLOOMY.COM study has investigated data from epidemiological, clinical and microbiological variables from six university hospitals in Germany that are associated with an increased risk of short and long-term consequences and a reduced quality of life in patients with a bloodstream infection. The data from the BLOOMY.COM study are used to derive a BLOOMY-PREDICTion rule to identify such risk groups, including the largest non-ICU (ICU = intensive care use) cohort of hospitalized patients with sepsis in Europe. A control cohort is required to verify the reproducibility of this BLOOMY-PREDICTion rule and to prevent overinterpretation of the data.

The aim of the BLOOMY-PREDICT project (Bloodstream Infection due to Multidrug-Resistant and Suceptible Organisms Multicenter Study - Prognostic scores in patients with bloodstream Infection) is therefore to verify this BLOOMY-PREDICTion rule in another cohort of BSI patients from five university hospitals in Germany. The project will draw on the infrastructure and preliminary work from the BLOOMY.COM study and will capture a similar, slightly reduced set of clinical and laboratory variables. Individual participating clinics will evaluate options for an improved score using modern biomarkers by taking additional blood samples. The follow-up period is six months. The validated BLOOMY.COM/BLOOMY-PREDICT score should ultimately be used to enable an optimized clinical treatment of BSI in order to reduce the risk of mortality and the frequency of severe secondary diseases. The validation of the score will provide new insights to subsequently design a multi-center interventional clinical trial with the aim of reducing the burden of sepsis, especially MRE bacteria, and ultimately enable optimized clinical management and individualized antibiotic therapy in routine patient care. The selection of high-risk patients could also provide essential information for the planning of clinical studies to test new antibiotics or antimicrobial stewardship interventions.