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

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-fatal...

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Detalles Bibliográficos
Autores principales: Giacobbe, Daniele Roberto, Battaglini, Denise, Enrile, Elisa Martina, Dentone, Chiara, Vena, Antonio, Robba, Chiara, Ball, Lorenzo, Bartoletti, Michele, Coloretti, Irene, Di Bella, Stefano, Di Biagio, Antonio, Brunetti, Iole, Mikulska, Malgorzata, Carannante, Novella, De Maria, Andrea, Magnasco, Laura, Maraolo, Alberto Enrico, Mirabella, Michele, Montrucchio, Giorgia, Patroniti, Nicolò, Taramasso, Lucia, Tiseo, Giusy, Fornaro, Giacomo, Fraganza, Fiorentino, Monastra, Luca, Roman-Pognuz, Erik, Paluzzano, Giacomo, Fiorentino, Giuseppe, Corcione, Antonio, Bussini, Linda, Pascale, Renato, Corcione, Silvia, Tonetti, Tommaso, Rinaldi, Matteo, Falcone, Marco, Biagioni, Emanuela, Ranieri, Vito Marco, Giannella, Maddalena, De Rosa, Francesco Giuseppe, Girardis, Massimo, Menichetti, Francesco, Viale, Pierluigi, Pelosi, Paolo, Bassetti, Matteo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913191/
https://www.ncbi.nlm.nih.gov/pubmed/33546093
http://dx.doi.org/10.3390/jcm10040555
Descripción
Sumario: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.

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