1. Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia
- Author
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Lakbar, Ines, Medam, Sophie, Ronflé, Romain, Cassir, Nadim, Delamarre, Louis, Hammad, Emmanuelle, Lopez, Alexandre, Lepape, Alain, Machut, Anaïs, Boucekine, Mohamed, Zieleskiewicz, Laurent, Baumstarck, Karine, Savey, Anne, Leone, Marc, Alfandari, Serge, Bailly, Sébastien, Bajolet, Odile, Baldesi, Olivier, Berger-Carbonne, Anne, Bollaert, Pierre-Edouard, Bretonniere, Cedric, Chatelet, Céline, Corne, Philippe, Durand-Joly, Isabelle, Friggeri, Arnaud, Gasan, Gaëlle, Gauzit, Rémy, Giard, Marine, Landelle, Caroline, Lavigne, Thierry, Lepelletier, Didier, Perrigault, Pierre-François, Picos, Santiago, Robaux, Marie-Aline, Stoeckel, Vincent, Timsit, Jean-François, Vanhems, Philippe, Hôpital Nord [CHU - APHM], Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), CHU Toulouse [Toulouse], Assistance Publique - Hôpitaux de Marseille (APHM), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CCLIN Sud-Est – Centre de Coordination de la Lutte contre les Infections Nosocomiales Sud-Est, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
- Subjects
Male ,medicine.medical_treatment ,health care facilities, manpower, and services ,law.invention ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,law ,Risk Factors ,Pneumonia, Staphylococcal ,030212 general & internal medicine ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Multidisciplinary ,Confounding ,Age Factors ,Enterobacteriaceae Infections ,Middle Aged ,Intensive care unit ,3. Good health ,Intensive Care Units ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Medicine ,Infectious diseases ,Female ,Acinetobacter Infections ,medicine.medical_specialty ,Science ,Microbiology ,Article ,03 medical and health sciences ,Antibiotic resistance ,Sex Factors ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Intensive care ,Internal medicine ,Drug Resistance, Bacterial ,Prohibitins ,medicine ,Pneumonia, Bacterial ,Humans ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,Pseudomonas Infections ,Clinical microbiology ,Aged ,Retrospective Studies ,Mechanical ventilation ,business.industry ,Healthcare-Associated Pneumonia ,Retrospective cohort study ,Odds ratio ,medicine.disease ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Pneumonia ,030228 respiratory system ,Bacterial infection ,business - Abstract
Data on the relationship between antimicrobial resistance and mortality remain scarce, and this relationship needs to be investigated in intensive care units (ICUs). The aim of this study was to compare the ICU mortality rates between patients with ICU-acquired pneumonia due to highly antimicrobial-resistant (HAMR) bacteria and those with ICU-acquired pneumonia due to non-HAMR bacteria. We conducted a multicenter, retrospective cohort study using the French National Surveillance Network for Healthcare Associated Infection in ICUs (“REA-Raisin”) database, gathering data from 200 ICUs from January 2007 to December 2016. We assessed all adult patients who were hospitalized for at least 48 h and presented with ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii. The association between pneumonia caused by HAMR bacteria and ICU mortality was analyzed using the whole sample and using a 1:2 matched sample. Among the 18,497 patients with at least one documented case of ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii, 3081 (16.4%) had HAMR bacteria. The HAMR group was associated with increased ICU mortality (40.3% vs. 30%, odds ratio (OR) 95%, CI 1.57 [1.45–1.70], P P P
- Published
- 2021
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