Prediction models of methicillin sensitive Staphylococcus aureus ventilator associated pneumonia relapse in trauma and brain injury patients: A retrospective analysis

Autor: Maël Gennequin, Nathalie Gault, Pierre-Antoine Allain, Jean Denis Moyer, Arnaud Foucrier, Maxens Decavèle
Přispěvatelé: Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158)
Rok vydání: 2021
Předmět:
Staphylococcus aureus
medicine.medical_specialty
Multivariate analysis
Ventilator associated pneumonia
030309 nutrition & dietetics
Critical Care and Intensive Care Medicine
medicine.disease_cause
Trauma
Brain injury patient
Cohort Studies
Ventilator associated pneumonia relapse
Methicillin
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
030225 pediatrics
Internal medicine
polycyclic compounds
medicine
Humans
Retrospective Studies
First episode
0303 health sciences
business.industry
Incidence (epidemiology)
Glasgow Coma Scale
Ventilator-associated pneumonia
Pneumonia
Ventilator-Associated
Odds ratio
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
medicine.disease
respiratory tract diseases
3. Good health
Methicillin Sensitive Staphylococcus aureus (MSSA)
Brain Injuries
bacteria
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Cohort study
Zdroj: Journal of Critical Care
Journal of Critical Care, WB Saunders, 2021, 66, pp.20-25. ⟨10.1016/j.jcrc.2021.07.021⟩
ISSN: 0883-9441
DOI: 10.1016/j.jcrc.2021.07.021
Popis: Purpose To describe the incidence and risk factors of methicillin sensitive Staphylococcus aureus ventilator associated pneumonia (MSSA-VAP) relapse in trauma and non-traumatic brain injury patients. Materials and methods Retrospective observational monocentric cohort study of consecutive ICU patients who developed a first episode of MSSA-VAP after trauma and non-traumatic brain injury. MSSA-VAP relapse encompass MSSA-VAP treatment failure (persistence or recurrence of MSSA) or other pathogen - VAP. Results A total of 165 patients (71% of trauma and 29% of non-traumatic brain injury) with MSSA-VAP were included. MSSA-VAP relapse occurred in 54 (33%) patients, including 28 (17%) MSSA-VAP treatment failure and 46 (28%) other pathogen-VAP. Empirical first-line antibiotic therapy was appropriate in 96% of cases. In multivariate analysis, the presence of Streptococcus species (Odds ratio [OR] 7.37) and oropharyngeal flora (OR 3.64) as initial MSSA co-pathogen, suggested aspiration at the time of admission and independently predicted MSSA-VAP treatment failure. Initial Glasgow coma scale (OR 0.89), need for emergent surgery (OR 5.71) and the presence of an acute respiratory distress syndrome at the time of the first MSSA-VAP (3.99), independently predicted the onset of other pathogen – VAP. Conclusion Early and simple factors may help to identify patients with high-risk of MSSA-VAP relapse.
Databáze: OpenAIRE
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