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2216. Pneumonia in the ICU: Epidemiology and Outcomes

BACKGROUND: The understanding of pneumonia epidemiology has been evolving in recent years with an increased awareness of viral respiratory pathogens since the introduction of respiratory pathogen panels. However, epidemiological and clinical data on pneumonia due to co-infection are lacking. METHODS...

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Autores principales: Blaha, Michael, Zelus, Casey, Cawcutt, Kelly, Marcelin, Jasmine R, Kalil, Andre C, Samson, Kaeli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810532/
http://dx.doi.org/10.1093/ofid/ofz360.1894
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author Blaha, Michael
Zelus, Casey
Cawcutt, Kelly
Cawcutt, Kelly
Marcelin, Jasmine R
Marcelin, Jasmine R
Kalil, Andre C
Samson, Kaeli
author_facet Blaha, Michael
Zelus, Casey
Cawcutt, Kelly
Cawcutt, Kelly
Marcelin, Jasmine R
Marcelin, Jasmine R
Kalil, Andre C
Samson, Kaeli
author_sort Blaha, Michael
collection PubMed
description BACKGROUND: The understanding of pneumonia epidemiology has been evolving in recent years with an increased awareness of viral respiratory pathogens since the introduction of respiratory pathogen panels. However, epidemiological and clinical data on pneumonia due to co-infection are lacking. METHODS: A single-center retrospective analysis of mechanically ventilated adult patients treated in critical care units from January to October 2018 was performed on patients with one or more pathogen identified via microbiological testing of a bronchoalveolar lavage (BAL) sample. SOFA and APACHE II scores at the time of admission to the critical care unit and SOFA the day the of BAL were obtained, along with ICU length of stay, duration of ventilation, and pathogens. Associations between categorical variables and co-infection status were assessed using Chi-Square tests, Fisher exact tests, and t-tests. Differences in counts of days between coinfection status groups were analyzed by generalized linear models. RESULTS: 140 bronchoalveolar lavage samples met inclusion criteria, of which 31 were determined to have co-infection with two or more pathogens identified. Of the two methods used to obtain BAL samples, co-infection was found in a higher proportion of patients undergoing bronchoscopic BAL as compared with blinded (35.6% vs. 7.5%; P < 0.0001). Patients with co-infection were determined to be statistically more likely to require a longer duration of mechanical ventilation (P = 0.03); however, there was no difference overall seen in 30 day mortality rate (23.4% vs. 19.57%; P = 0.61). CONCLUSION: Co-infection is a significant risk factor for a prolonged duration of mechanical ventilation compared with patients with single pathogen pneumonia. In addition, the use of bronchoscopic BAL appears to be a significant factor in identifying higher rates of co-infection compared with blinded. Although our study failed to demonstrate a significant difference in mortality rates, this could have occurred due to the small sample size. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68105322019-10-28 2216. Pneumonia in the ICU: Epidemiology and Outcomes Blaha, Michael Zelus, Casey Cawcutt, Kelly Cawcutt, Kelly Marcelin, Jasmine R Marcelin, Jasmine R Kalil, Andre C Samson, Kaeli Open Forum Infect Dis Abstracts BACKGROUND: The understanding of pneumonia epidemiology has been evolving in recent years with an increased awareness of viral respiratory pathogens since the introduction of respiratory pathogen panels. However, epidemiological and clinical data on pneumonia due to co-infection are lacking. METHODS: A single-center retrospective analysis of mechanically ventilated adult patients treated in critical care units from January to October 2018 was performed on patients with one or more pathogen identified via microbiological testing of a bronchoalveolar lavage (BAL) sample. SOFA and APACHE II scores at the time of admission to the critical care unit and SOFA the day the of BAL were obtained, along with ICU length of stay, duration of ventilation, and pathogens. Associations between categorical variables and co-infection status were assessed using Chi-Square tests, Fisher exact tests, and t-tests. Differences in counts of days between coinfection status groups were analyzed by generalized linear models. RESULTS: 140 bronchoalveolar lavage samples met inclusion criteria, of which 31 were determined to have co-infection with two or more pathogens identified. Of the two methods used to obtain BAL samples, co-infection was found in a higher proportion of patients undergoing bronchoscopic BAL as compared with blinded (35.6% vs. 7.5%; P < 0.0001). Patients with co-infection were determined to be statistically more likely to require a longer duration of mechanical ventilation (P = 0.03); however, there was no difference overall seen in 30 day mortality rate (23.4% vs. 19.57%; P = 0.61). CONCLUSION: Co-infection is a significant risk factor for a prolonged duration of mechanical ventilation compared with patients with single pathogen pneumonia. In addition, the use of bronchoscopic BAL appears to be a significant factor in identifying higher rates of co-infection compared with blinded. Although our study failed to demonstrate a significant difference in mortality rates, this could have occurred due to the small sample size. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810532/ http://dx.doi.org/10.1093/ofid/ofz360.1894 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Blaha, Michael
Zelus, Casey
Cawcutt, Kelly
Cawcutt, Kelly
Marcelin, Jasmine R
Marcelin, Jasmine R
Kalil, Andre C
Samson, Kaeli
2216. Pneumonia in the ICU: Epidemiology and Outcomes
title 2216. Pneumonia in the ICU: Epidemiology and Outcomes
title_full 2216. Pneumonia in the ICU: Epidemiology and Outcomes
title_fullStr 2216. Pneumonia in the ICU: Epidemiology and Outcomes
title_full_unstemmed 2216. Pneumonia in the ICU: Epidemiology and Outcomes
title_short 2216. Pneumonia in the ICU: Epidemiology and Outcomes
title_sort 2216. pneumonia in the icu: epidemiology and outcomes
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810532/
http://dx.doi.org/10.1093/ofid/ofz360.1894
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