4 research outputs found

    The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

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    Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

    Pengembangan Aplikasi E-Commerce

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    Perkembangan teknologi dalam kehidupan dimulai dari proses sederhana dalam kehidupan sehari-hari sampai pada tingkat pemenuhan kepuasan sebagai individu dan makhluk sosial. Dari masa ke masa kemajuan teknologi terus berkembang, mulai dari era teknologi pertanian, era teknologi industri, era teknologi informasi, dan era teknologi komunikasi dan informasi. Perkembangan ini membawa berbagai dampak dalam kehidupan bermasayarakat, berbangsa dan bernegara, setiap individu tertarik untuk mengunakan dan memanfaatkan setiap perkembangan ini. Berbeda dengan perkembangan aplikasi di dunia nyata yang bermula dari paket-paket aplikasi yang bersifat fungsional, di dunia maya beragam aplikasi e-commerce dibangun berdasarkan paradigma proses (business process)

    Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study

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    377siBackground: Patient factors associated with urinary tract cancer can be used to risk stratify patients referred with haematuria, prioritising those with a higher risk of cancer for prompt investigation. Objective: To develop a prediction model for urinary tract cancer in patients referred with haematuria. Design, setting, and participants: A prospective observational study was conducted in 10 282 patients from 110 hospitals across 26 countries, aged ≥16 yr and referred to secondary care with haematuria. Patients with a known or previous urological malignancy were excluded. Outcome measurements and statistical analysis: The primary outcomes were the presence or absence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC], and renal cancer). Mixed-effect multivariable logistic regression was performed with site and country as random effects and clinically important patient-level candidate predictors, chosen a priori, as fixed effects. Predictors were selected primarily using clinical reasoning, in addition to backward stepwise selection. Calibration and discrimination were calculated, and bootstrap validation was performed to calculate optimism. Results and limitations: The unadjusted prevalence was 17.2% (n = 1763) for bladder cancer, 1.20% (n = 123) for UTUC, and 1.00% (n = 103) for renal cancer. The final model included predictors of increased risk (visible haematuria, age, smoking history, male sex, and family history) and reduced risk (previous haematuria investigations, urinary tract infection, dysuria/suprapubic pain, anticoagulation, catheter use, and previous pelvic radiotherapy). The area under the receiver operating characteristic curve of the final model was 0.86 (95% confidence interval 0.85-0.87). The model is limited to patients without previous urological malignancy. Conclusions: This cancer prediction model is the first to consider established and novel urinary tract cancer diagnostic markers. It can be used in secondary care for risk stratifying patients and aid the clinician's decision-making process in prioritising patients for investigation. Patient summary: We have developed a tool that uses a person's characteristics to determine the risk of cancer if that person develops blood in the urine (haematuria). This can be used to help prioritise patients for further investigation.noneopenKhadhouri, Sinan; Gallagher, Kevin M.; MacKenzie, Kenneth R.; Shah, Taimur T.; Gao, Chuanyu; Moore, Sacha; Zimmermann, Eleanor F.; Edison, Eric; Jefferies, Matthew; Nambiar, Arjun; Anbarasan, Thineskrishna; Mannas, Miles P.; Lee, Taeweon; Marra, Giancarlo; Gómez Rivas, Juan; Marcq, Gautier; Assmus, Mark A.; Uçar, Taha; Claps, Francesco; Boltri, Matteo; La Montagna, Giuseppe; Burnhope, Tara; Nkwam, Nkwam; Austin, Tomas; Boxall, Nicholas E.; Downey, Alison P.; Sukhu, Troy A.; Antón-Juanilla, Marta; Rai, Sonpreet; Chin, Yew-Fung; Moore, Madeline; Drake, Tamsin; Green, James S.A.; Goulao, Beatriz; MacLennan, Graeme; Nielsen, Matthew; McGrath, John S.; Kasivisvanathan, Veeru; Chaudry, Aasem; Sharma, Abhishek; Bennett, Adam; Ahmad, Adnan; Abroaf, Ahmed; Suliman, Ahmed Musa; Lloyd, Aimee; McKay, Alastair; Wong, Albert; Silva, Alberto; Schneider, Alexandre; MacKay, Alison; Knight, Allen; Grigorakis, Alkiviadis; Bdesha, Amar; Nagle, Amy; Cebola, Ana; Dhanasekaran, Ananda Kumar; Kondža, Andraž; Barcelos, André; Galosi, Andrea Benedetto; Ebur, Andrea; Minervini, Andrea; Russell, Andrew; Webb, Andrew; de Jalón, Ángel García; Desai, Ankit; Czech, Anna Katarzyna; Mainwaring, Anna; Adimonye, Anthony; Das, Arighno; Figueiredo, Arnaldo; Villers, Arnauld; Leminski, Artur; Chippagiri, Arvinda; Lal, Asim Ahmed; Yıldırım, Asıf; Voulgaris, Athanasios Marios; Uzan, Audrey; Oo, Aye Moh Moh; Younis, Ayman; Zelhof, Bachar; Mukhtar, Bashir; Ayres, Ben; Challacombe, Ben; Sherwood, Benedict; Ristau, Benjamin; Lai, Billy; Nellensteijn, Brechtje; Schreiter, Brielle; Trombetta, Carlo; Dowling, Catherine; Hobbs, Catherine; Benitez, Cayo Augusto Estigarribia; Lebacle, Cédric; Ho, Cherrie Wing Yin; Ng, Chi-Fai; Mount, Chloe; Lam, Chon Meng; Blick, Chris; Brown, Christian; Gallegos, Christopher; Higgs, Claire; Browne, Clíodhna; McCann, Conor; Plaza Alonso, Cristina; Beder, Daniel; Cohen, Daniel; Gordon, Daniel; Wilby, Daniel; Gordon, Danny; Hrouda, David; Lau, David Hua Wu; Karsza, Dávid; Mak, David; Martin-Way, David; Suthaharan, Denula; Patel, Dhruv; Carrion, Diego M; Nyanhongo, Donald; Bass, Edward; Mains, Edward; Chau, Edwin; Canelon Castillo, Elba; Day, Elizabeth; Desouky, Elsayed; Gaines, Emily; Papworth, Emma; Yuruk, Emrah; Kilic, Enes; Dinneen, Eoin; Palagonia, Erika; Xylinas, Evanguelos; Khawaja, Faizan; Cimarra, Fernando; Bardet, Florian; Kum, Francesca; Peters, Francesca; Kovács, Gábor; Tanasescu, Geroge; Hellawell, Giles; Tasso, Giovanni; Lam, Gitte; La Montagna, Giuseppe; Pizzuto, Giuseppe; Lenart, Gordan; MacLennan, Graeme; Özgür, Günal; Bi, Hai; Lyons, Hannah; Warren, Hannah; Ahmed, Hashim; Simpson, Helen; Burden, Helena; Gresty, Helena; Rios Pita, Hernado; Clarke, Holly; Serag, Hosam; Kynaston, Howard; Crawford-Smith, Hugh; Mostafid, Hugh; Otaola-Arca, Hugo; Koo, Hui Fen; Ibrahim, Ibrahim; Ouzaid, Idir; Puche-Sanz, Ignacio; Tomašković, Igor; Tinay, Ilker; Sahibzada, Iqbal; Thangasamy, Isaac; Cadena, Iván Revelo; Irani, Jacques; Udzik, Jakub; Brittain, James; Catto, James; Green, James; Tweedle, James; Hernando, Jamie Borrego; Leask, Jamie; Kalsi, Jas; Frankel, Jason; Toniolo, Jason; Raman, Jay D.; Courcier, Jean; Kumaradeevan, Jeevan; Clark, Jennifer; Jones, Jennifer; Teoh, Jeremy Yuen-Chun; Iacovou, John; Kelly, John; Selph, John P.; Aning, Jonathan; Deeks, Jon; Cobley, Jonathan; Olivier, Jonathan; Maw, Jonny; Herranz-Yagüe, José Antonio; Nolazco, Jose Ignacio; Cózar-Olmo, Jose Manuel; Bagley, Joseph; Jelski, Joseph; Norris, Joseph; Testa, Joseph; Meeks, Joshua; Hernandez, Juan; Vásquez, Juan Luis; Randhawa, Karen; Dhera, Karishma; Gronostaj, Katarzyna; Houlton, Kathleen; Lehman, Kathleen; Gillams, Kathryn; Adasonla, Kelvin; Brown, Kevin; Murtagh, Kevin; Mistry, Kiki; Davenport, Kim; Kitamura, Kosuke; Derbyshire, Laura; Clarke, Laurence; Morton, Lawrie; Martinez, Levin; Goldsmith, Louise; Paramore, Louise; Cormier, Luc; Dell'Atti, Lucio; Simmons, Lucy; Martinez-Piñeiro, Luis; Rico, Luis; Chan, Luke; Forster, Luke; Ma, Lulin; Moore, Madeline; Gallego, Maria Camacho; Freire, Maria José; Emberton, Mark; Feneley, Mark; Antón-Juanilla, Marta; Rivero, Marta Viridiana Muñoz; Pirša, Matea; Tallè, Matteo; Crockett, Matthew; Liew, Matthew; Trail, Matthew; Peters, Max; Cooper, Meghan; Kulkarni, Meghana; Ager, Michael; He, Ming; Li, Mo; Omran Breish, Mohamed; Tarin, Mohamed; Aldiwani, Mohammed; Matanhelia, Mudit; Pasha, Muhammad; Akalın, Mustafa Kaan; Abdullah, Nasreen; Hale, Nathan; Gadiyar, Neha; Kocher, Neil; Bullock, Nicholas; Campain, Nicholas; Pavan, Nicola; Al-Ibraheem, Nihad; Bhatt, Nikita; Bedi, Nishant; Shrotri, Nitin; Lobo, Niyati; Balderas, Olga; Kouli, Omar; Capoun, Otakar; Oteo Manjavacas, Pablo; Gontero, Paolo; Mariappan, Paramananthan; Marchiñena, Patricio Garcia; Erotocritou, Paul; Sweeney, Paul; Planelles, Paula; Acher, Peter; Black, Peter C.; Osei-Bonsu, Peter K; Østergren, Peter; Smith, Peter; Willemse, Peter-Paul Michiel; Chlosta, Piotr L.; Ul Ain, Qurrat; Barratt, Rachel; Esler, Rachel; Khalid, Raihan; Hsu, Ray; Stamirowski, Remigiusz; Mangat, Reshma; Cruz, Ricardo; Ellis, Ricky; Adams, Robert; Hessell, Robert; Oomen, Robert J.A.; McConkey, Robert; Ritchie, Robert; Jarimba, Roberto; Chahal, Rohit; Andres, Rosado Mario; Hawkins, Rosalyn; David, Rotimi; Manecksha, Rustom P.; Agrawal, Sachin; Hamid, Syed Sami; Deem, Samuel; Goonewardene, Sanchia; Swami, Satchi Kuchibhotla; Hori, Satoshi; Khan, Shahid; Mohammud Inder, Shakeel; Sangaralingam, Shanthi; Marathe, Shekhar; Raveenthiran, Sheliyan; Horie, Shigeo; Sengupta, Shomik; Parson, Sian; Parker, Sidney; Hawlina, Simon; Williams, Simon; Mazzoli, Simone; Grzegorz Kata, Slawomir; Pinheiro Lopes, Sofia; Ramos, Sónia; Rai, Sonpreet; Rintoul-Hoad, Sophie; O'Meara, Sorcha; Morris, Steve; Turner, Stacey; Venturini, Stefano; Almpanis, Stephanos; Joniau, Steven; Jain, Sunjay; Mallett, Susan; Nikles, Sven; Shahzad, null; Yan, Sylvia; Lee, Taeweon; Uçar, Taha; Drake, Tamsin; Toma, Tarq; Cabañuz Plo, Teresa; Bonnin, Thierry; Muilwijk, Tim; Wollin, Tim; Chu, Timothy Shun Man; Appanna, Timson; Brophy, Tom; Ellul, Tom; Austin, Tomas; Smrkolj, Tomaž; Rowe, Tracey; Sukhu, Troy; Patel, Trushar; Garg, Tullika; Çaşkurlu, Turhan; Bele, Uros; Haroon, Usman; Crespo-Atín, Víctor; Parejo Cortes, Victor; Capapé Poves, Victoria; Gnanapragasam, Vincent; Gauhar, Vineet; During, Vinnie; Kumar, Vivek; Fiala, Vojtech; Mahmalji, Wasim; Lam, Wayne; Fung Chin, Yew; Filtekin, Yigit; Chyn Phan, Yih; Ibrahim, Youssed; Glaser, Zachary A; Abiddin, Zainal Adwin; Qin, Zijian; Zotter, Zsuzsanna; Zainuddin, ZulkifliKhadhouri, Sinan; Gallagher, Kevin M.; Mackenzie, Kenneth R.; Shah, Taimur T.; Gao, Chuanyu; Moore, Sacha; Zimmermann, Eleanor F.; Edison, Eric; Jefferies, Matthew; Nambiar, Arjun; Anbarasan, Thineskrishna; Mannas, Miles P.; Lee, Taeweon; Marra, Giancarlo; Gómez Rivas, Juan; Marcq, Gautier; Assmus, Mark A.; Uçar, Taha; Claps, Francesco; Boltri, Matteo; La Montagna, Giuseppe; Burnhope, Tara; Nkwam, Nkwam; Austin, Tomas; Boxall, Nicholas E.; Downey, Alison P.; Sukhu, Troy A.; Antón-Juanilla, Marta; Rai, Sonpreet; Chin, Yew-Fung; Moore, Madeline; Drake, Tamsin; Green, James S. A.; Goulao, Beatriz; Maclennan, Graeme; Nielsen, Matthew; Mcgrath, John S.; Kasivisvanathan, Veeru; Chaudry, Aasem; Sharma, Abhishek; Bennett, Adam; Ahmad, Adnan; Abroaf, Ahmed; Suliman, Ahmed Musa; Lloyd, Aimee; Mckay, Alastair; Wong, Albert; Silva, Alberto; Schneider, Alexandre; Mackay, Alison; Knight, Allen; Grigorakis, Alkiviadis; Bdesha, Amar; Nagle, Amy; Cebola, Ana; Dhanasekaran, Ananda Kumar; Kondža, Andraž; Barcelos, André; Galosi, Andrea Benedetto; Ebur, Andrea; Minervini, Andrea; Russell, Andrew; Webb, Andrew; de Jalón, Ángel García; Desai, Ankit; Czech, Anna Katarzyna; Mainwaring, Anna; Adimonye, Anthony; Das, Arighno; Figueiredo, Arnaldo; Villers, Arnauld; Leminski, Artur; Chippagiri, Arvinda; Lal, Asim Ahmed; Yıldırım, Asıf; Voulgaris, Athanasios Marios; Uzan, Audrey; Oo, Aye Moh Moh; Younis, Ayman; Zelhof, Bachar; Mukhtar, Bashir; Ayres, Ben; Challacombe, Ben; Sherwood, Benedict; Ristau, Benjamin; Lai, Billy; Nellensteijn, Brechtje; Schreiter, Brielle; Trombetta, Carlo; Dowling, Catherine; Hobbs, Catherine; Benitez, Cayo Augusto Estigarribia; Lebacle, Cédric; Ho, Cherrie Wing Yin; Ng, Chi-Fai; Mount, Chloe; Lam, Chon Meng; Blick, Chris; Brown, Christian; Gallegos, Christopher; Higgs, Claire; Browne, Clíodhna; Mccann, Conor; Plaza Alonso, Cristina; Beder, Daniel; Cohen, Daniel; Gordon, Daniel; Wilby, Daniel; Gordon, Danny; Hrouda, David; Lau, David Hua Wu; Karsza, Dávid; Mak, David; Martin-Way, David; Suthaharan, Denula; Patel, Dhruv; Carrion, Diego M; Nyanhongo, Donald; Bass, Edward; Mains, Edward; Chau, Edwin; Canelon Castillo, Elba; Day, Elizabeth; Desouky, Elsayed; Gaines, Emily; Papworth, Emma; Yuruk, Emrah; Kilic, Enes; Dinneen, Eoin; Palagonia, Erika; Xylinas, Evanguelos; Khawaja, Faizan; Cimarra, Fernando; Bardet, Florian; Kum, Francesca; Peters, Francesca; Kovács, Gábor; Tanasescu, Geroge; Hellawell, Giles; Tasso, Giovanni; Lam, Gitte; La Montagna, Giuseppe; Pizzuto, Giuseppe; Lenart, Gordan; Maclennan, Graeme; Özgür, Günal; Bi, Hai; Lyons, Hannah; Warren, Hannah; Ahmed, Hashim; Simpson, Helen; Burden, Helena; Gresty, Helena; Rios Pita, Hernado; Clarke, Holly; Serag, Hosam; Kynaston, Howard; Crawford-Smith, Hugh; Mostafid, Hugh; Otaola-Arca, Hugo; Koo, Hui Fen; Ibrahim, Ibrahim; Ouzaid, Idir; Puche-Sanz, Ignacio; Tomašković, Igor; Tinay, Ilker; Sahibzada, Iqbal; Thangasamy, Isaac; Cadena, Iván Revelo; Irani, Jacques; Udzik, Jakub; Brittain, James; Catto, James; Green, James; Tweedle, James; Hernando, Jamie Borrego; Leask, Jamie; Kalsi, Jas; Frankel, Jason; Toniolo, Jason; Raman, Jay D.; Courcier, Jean; Kumaradeevan, Jeevan; Clark, Jennifer; Jones, Jennifer; Teoh, Jeremy Yuen-Chun; Iacovou, John; Kelly, John; Selph, John P.; Aning, Jonathan; Deeks, Jon; Cobley, Jonathan; Olivier, Jonathan; Maw, Jonny; Herranz-Yagüe, José Antonio; Nolazco, Jose Ignacio; Cózar-Olmo, Jose Manuel; Bagley, Joseph; Jelski, Joseph; Norris, Joseph; Testa, Joseph; Meeks, Joshua; Hernandez, Juan; Vásquez, Juan Luis; Randhawa, Karen; Dhera, Karishma; Gronostaj, Katarzyna; Houlton, Kathleen; Lehman, Kathleen; Gillams, Kathryn; Adasonla, Kelvin; Brown, Kevin; Murtagh, Kevin; Mistry, Kiki; Davenport, Kim; Kitamura, Kosuke; Derbyshire, Laura; Clarke, Laurence; Morton, Lawrie; Martinez, Levin; Goldsmith, Louise; Paramore, Louise; Cormier, Luc; Dell'Atti, Lucio; Simmons, Lucy; Martinez-Piñeiro, Luis; Rico, Luis; Chan, Luke; Forster, Luke; Ma, Lulin; Moore, Madeline; Gallego, Maria Camacho; Freire, Maria José; Emberton, Mark; Feneley, Mark; Antón-Juanilla, Marta; Rivero, Marta Viridiana Muñoz; Pirša, Matea; Tallè, Matteo; Crockett, Matthew; Liew, Matthew; Trail, Matthew; Peters, Max; Cooper, Meghan; Kulkarni, Meghana; Ager, Michael; He, Ming; Li, Mo; Omran Breish, Mohamed; Tarin, Mohamed; Aldiwani, Mohammed; Matanhelia, Mudit; Pasha, Muhammad; Akalın, Mustafa Kaan; Abdullah, Nasreen; Hale, Nathan; Gadiyar, Neha; Kocher, Neil; Bullock, Nicholas; Campain, Nicholas; Pavan, Nicola; Al-Ibraheem, Nihad; Bhatt, Nikita; Bedi, Nishant; Shrotri, Nitin; Lobo, Niyati; Balderas, Olga; Kouli, Omar; Capoun, Otakar; Oteo Manjavacas, Pablo; Gontero, Paolo; Mariappan, Paramananthan; Marchiñena, Patricio Garcia; Erotocritou, Paul; Sweeney, Paul; Planelles, Paula; Acher, Peter; Black, Peter C.; Osei-Bonsu, Peter K; Østergren, Peter; Smith, Peter; Willemse, Peter-Paul Michiel; Chlosta, Piotr L.; Ul Ain, Qurrat; Barratt, Rachel; Esler, Rachel; Khalid, Raihan; Hsu, Ray; Stamirowski, Remigiusz; Mangat, Reshma; Cruz, Ricardo; Ellis, Ricky; Adams, Robert; Hessell, Robert; Oomen, Robert J. A.; Mcconkey, Robert; Ritchie, Robert; Jarimba, Roberto; Chahal, Rohit; Andres, Rosado Mario; Hawkins, Rosalyn; David, Rotimi; Manecksha, Rustom P.; Agrawal, Sachin; Hamid, Syed Sami; Deem, Samuel; Goonewardene, Sanchia; Swami, Satchi Kuchibhotla; Hori, Satoshi; Khan, Shahid; Mohammud Inder, Shakeel; Sangaralingam, Shanthi; Marathe, Shekhar; Raveenthiran, Sheliyan; Horie, Shigeo; Sengupta, Shomik; Parson, Sian; Parker, Sidney; Hawlina, Simon; Williams, Simon; Mazzoli, Simone; Grzegorz Kata, Slawomir; Pinheiro Lopes, Sofia; Ramos, Sónia; Rai, Sonpreet; Rintoul-Hoad, Sophie; O'Meara, Sorcha; Morris, Steve; Turner, Stacey; Venturini, Stefano; Almpanis, Stephanos; Joniau, Steven; Jain, Sunjay; Mallett, Susan; Nikles, Sven; Shahzad, Null; Yan, Sylvia; Lee, Taeweon; Uçar, Taha; Drake, Tamsin; Toma, Tarq; Cabañuz Plo, Teresa; Bonnin, Thierry; Muilwijk, Tim; Wollin, Tim; Chu, Timothy Shun Man; Appanna, Timson; Brophy, Tom; Ellul, Tom; Austin, Tomas; Smrkolj, Tomaž; Rowe, Tracey; Sukhu, Troy; Patel, Trushar; Garg, Tullika; Çaşkurlu, Turhan; Bele, Uros; Haroon, Usman; Crespo-Atín, Víctor; Parejo Cortes, Victor; Capapé Poves, Victoria; Gnanapragasam, Vincent; Gauhar, Vineet; During, Vinnie; Kumar, Vivek; Fiala, Vojtech; Mahmalji, Wasim; Lam, Wayne; Fung Chin, Yew; Filtekin, Yigit; Chyn Phan, Yih; Ibrahim, Youssed; Glaser, Zachary A; Abiddin, Zainal Adwin; Qin, Zijian; Zotter, Zsuzsanna; Zainuddin, Zulkifl

    Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

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    Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes
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