Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study.

Autor: Giacobbe DR; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Battaglini D; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Enrile EM; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy., Dentone C; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Vena A; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Robba C; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy., Ball L; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy., Bartoletti M; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Coloretti I; Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy., Di Bella S; Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy., Di Biagio A; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy., Brunetti I; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Mikulska M; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy., Carannante N; Emergenza Infettivologica PS, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy., De Maria A; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy., Magnasco L; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy., Maraolo AE; First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy., Mirabella M; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy., Montrucchio G; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.; Unit of Anesthesia and Resuscitation 1, Department of Anesthesia, Intensive Care, and Emergency, Città della Salute e della Scienza, 10126 Turin, Italy., Patroniti N; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy., Taramasso L; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy., Tiseo G; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy., Fornaro G; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Fraganza F; Intensive Care Unit, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy., Monastra L; Intensive Care Unit, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy., Roman-Pognuz E; Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy.; Department of Anesthesia and Intensive Care Medicine; Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), 34148 Trieste, Italy., Paluzzano G; Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy., Fiorentino G; SubIntensiva Covid, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy., Corcione A; Dipartimento Area Critica, AORN dei Colli, 80131 Naples, Italy., Bussini L; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Pascale R; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Corcione S; Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy., Tonetti T; Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Rinaldi M; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Falcone M; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy., Biagioni E; Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy., Ranieri VM; Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Giannella M; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., De Rosa FG; Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy., Girardis M; Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy., Menichetti F; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy., Viale P; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, 40138 Bologna, Italy., Pelosi P; Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy., Bassetti M; Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.; Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2021 Feb 03; Vol. 10 (4). Date of Electronic Publication: 2021 Feb 03.
DOI: 10.3390/jcm10040555
Abstrakt: The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16-21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43-7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05-57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
Databáze: MEDLINE
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