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European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI
PURPOSE: Lower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcom...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562498/ https://www.ncbi.nlm.nih.gov/pubmed/37812242 http://dx.doi.org/10.1007/s00134-023-07210-9 |
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author | Martin-Loeches, Ignacio Reyes, Luis Felipe Nseir, Saad Ranzani, Otavio Povoa, Pedro Diaz, Emili Schultz, Marcus J. Rodríguez, Alejandro H. Serrano-Mayorga, Cristian C. De Pascale, Gennaro Navalesi, Paolo Panigada, Mauro Coelho, Luis Miguel Skoczynski, Szymon Esperatti, Mariano Cortegiani, Andrea Aliberti, Stefano Caricato, Anselmo Salzer, Helmut J. F. Ceccato, Adrian Civljak, Rok Soave, Paolo Maurizio Luyt, Charles-Edouard Ekren, Pervin Korkmaz Rios, Fernando Masclans, Joan Ramon Marin, Judith Iglesias-Moles, Silvia Nava, Stefano Chiumello, Davide Bos, Lieuwe D. Artigas, Antoni Froes, Filipe Grimaldi, David Taccone, Fabio Silvio Antonelli, Massimo Torres, Antoni |
author_facet | Martin-Loeches, Ignacio Reyes, Luis Felipe Nseir, Saad Ranzani, Otavio Povoa, Pedro Diaz, Emili Schultz, Marcus J. Rodríguez, Alejandro H. Serrano-Mayorga, Cristian C. De Pascale, Gennaro Navalesi, Paolo Panigada, Mauro Coelho, Luis Miguel Skoczynski, Szymon Esperatti, Mariano Cortegiani, Andrea Aliberti, Stefano Caricato, Anselmo Salzer, Helmut J. F. Ceccato, Adrian Civljak, Rok Soave, Paolo Maurizio Luyt, Charles-Edouard Ekren, Pervin Korkmaz Rios, Fernando Masclans, Joan Ramon Marin, Judith Iglesias-Moles, Silvia Nava, Stefano Chiumello, Davide Bos, Lieuwe D. Artigas, Antoni Froes, Filipe Grimaldi, David Taccone, Fabio Silvio Antonelli, Massimo Torres, Antoni |
author_sort | Martin-Loeches, Ignacio |
collection | PubMed |
description | PURPOSE: Lower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcomes. METHODS: A prospective observational study was conducted in 13 countries over two continents from 9th May 2016 until 16th August 2019. Characteristics and outcomes of ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), ICU hospital-acquired pneumonia (ICU-HAP), HAP that required invasive ventilation (VHAP), and HAP in patients transferred to the ICU without invasive mechanical ventilation were collected. The clinical diagnosis and treatments were per clinical practice and not per protocol. Descriptive statistics were used to compare the study groups. RESULTS: 1060 patients with LRTI (72.5% male sex, median age 64 [50–74] years) were included in the study; 160 (15.1%) developed VAT, 556 (52.5%) VAP, 98 (9.2%) ICU-HAP, 152 (14.3%) HAP, and 94 (8.9%) VHAP. Patients with VHAP had higher serum procalcitonin (PCT) and Sequential Organ Failure Assessment (SOFA) scores. Patients with VAP or VHAP developed acute kidney injury, acute respiratory distress syndrome, multiple organ failure, or septic shock more often. One thousand eight patients had microbiological samples, and 711 (70.5%) had etiological microbiology identified. The most common microorganisms were Pseudomonas aeruginosa (18.4%) and Klebsiella spp (14.4%). In 382 patients (36%), the causative pathogen shows some antimicrobial resistance pattern. ICU, hospital and 28-day mortality were 30.8%, 37.5% and 27.5%, respectively. Patients with VHAP had the highest ICU, in-hospital and 28-day mortality rates. CONCLUSION: VHAP patients presented the highest mortality among those admitted to the ICU. Multidrug-resistant pathogens frequently cause nosocomial LRTI in this multinational cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00134-023-07210-9. |
format | Online Article Text |
id | pubmed-10562498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105624982023-10-11 European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI Martin-Loeches, Ignacio Reyes, Luis Felipe Nseir, Saad Ranzani, Otavio Povoa, Pedro Diaz, Emili Schultz, Marcus J. Rodríguez, Alejandro H. Serrano-Mayorga, Cristian C. De Pascale, Gennaro Navalesi, Paolo Panigada, Mauro Coelho, Luis Miguel Skoczynski, Szymon Esperatti, Mariano Cortegiani, Andrea Aliberti, Stefano Caricato, Anselmo Salzer, Helmut J. F. Ceccato, Adrian Civljak, Rok Soave, Paolo Maurizio Luyt, Charles-Edouard Ekren, Pervin Korkmaz Rios, Fernando Masclans, Joan Ramon Marin, Judith Iglesias-Moles, Silvia Nava, Stefano Chiumello, Davide Bos, Lieuwe D. Artigas, Antoni Froes, Filipe Grimaldi, David Taccone, Fabio Silvio Antonelli, Massimo Torres, Antoni Intensive Care Med Original PURPOSE: Lower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcomes. METHODS: A prospective observational study was conducted in 13 countries over two continents from 9th May 2016 until 16th August 2019. Characteristics and outcomes of ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), ICU hospital-acquired pneumonia (ICU-HAP), HAP that required invasive ventilation (VHAP), and HAP in patients transferred to the ICU without invasive mechanical ventilation were collected. The clinical diagnosis and treatments were per clinical practice and not per protocol. Descriptive statistics were used to compare the study groups. RESULTS: 1060 patients with LRTI (72.5% male sex, median age 64 [50–74] years) were included in the study; 160 (15.1%) developed VAT, 556 (52.5%) VAP, 98 (9.2%) ICU-HAP, 152 (14.3%) HAP, and 94 (8.9%) VHAP. Patients with VHAP had higher serum procalcitonin (PCT) and Sequential Organ Failure Assessment (SOFA) scores. Patients with VAP or VHAP developed acute kidney injury, acute respiratory distress syndrome, multiple organ failure, or septic shock more often. One thousand eight patients had microbiological samples, and 711 (70.5%) had etiological microbiology identified. The most common microorganisms were Pseudomonas aeruginosa (18.4%) and Klebsiella spp (14.4%). In 382 patients (36%), the causative pathogen shows some antimicrobial resistance pattern. ICU, hospital and 28-day mortality were 30.8%, 37.5% and 27.5%, respectively. Patients with VHAP had the highest ICU, in-hospital and 28-day mortality rates. CONCLUSION: VHAP patients presented the highest mortality among those admitted to the ICU. Multidrug-resistant pathogens frequently cause nosocomial LRTI in this multinational cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00134-023-07210-9. Springer Berlin Heidelberg 2023-10-09 2023 /pmc/articles/PMC10562498/ /pubmed/37812242 http://dx.doi.org/10.1007/s00134-023-07210-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Martin-Loeches, Ignacio Reyes, Luis Felipe Nseir, Saad Ranzani, Otavio Povoa, Pedro Diaz, Emili Schultz, Marcus J. Rodríguez, Alejandro H. Serrano-Mayorga, Cristian C. De Pascale, Gennaro Navalesi, Paolo Panigada, Mauro Coelho, Luis Miguel Skoczynski, Szymon Esperatti, Mariano Cortegiani, Andrea Aliberti, Stefano Caricato, Anselmo Salzer, Helmut J. F. Ceccato, Adrian Civljak, Rok Soave, Paolo Maurizio Luyt, Charles-Edouard Ekren, Pervin Korkmaz Rios, Fernando Masclans, Joan Ramon Marin, Judith Iglesias-Moles, Silvia Nava, Stefano Chiumello, Davide Bos, Lieuwe D. Artigas, Antoni Froes, Filipe Grimaldi, David Taccone, Fabio Silvio Antonelli, Massimo Torres, Antoni European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title | European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title_full | European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title_fullStr | European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title_full_unstemmed | European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title_short | European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI |
title_sort | european network for icu-related respiratory infections (enirris): a multinational, prospective, cohort study of nosocomial lrti |
topic | Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562498/ https://www.ncbi.nlm.nih.gov/pubmed/37812242 http://dx.doi.org/10.1007/s00134-023-07210-9 |
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