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Ventilator-associated bacterial pneumonia in coronavirus 2019 disease, a retrospective monocentric cohort study
- Source :
- Journal of Infection and Chemotherapy
- Publication Year :
- 2021
- Publisher :
- Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd., 2021.
-
Abstract
- Introduction Severe coronavirus 2019 disease (CoViD-19) may lead to respiratory failure and mechanical ventilation. Therefore, ventilator associated pneumonia (VAP) may complicate the course of the disease. The aim of the current article was to investigate possible predictive factors for bacterial VAP on a retrospective manner, in a cohort of mechanically ventilated CoViD-19 patients. Additionally, determinant factors of lethality were analyzed. Methods Medical records of patients hospitalized in the intensive care units (ICU) at the university hospital UZ Brussel during the epidemic were reviewed. VAP was defined following the National Healthcare Safety Network 2017 criteria. Univariate and multivariate logistic regressions analyses were performed. Results Among the 39 patients included in the study, 54% were diagnosed with bacterial VAP. Case fatality rate was 44%, but 59% of the deceased patients had a do-not-resuscitate status. Multivariate logistic regression for prediction of VAP showed significant differences in duration of ICU hospitalization and in minimal lung compliance. Additional analyses were performed on CoViD-19 patients who were affected by bacterial respiratory superinfection. The responsible pathogens correspond to the commonly found bacteria in VAP. However, 71% of the isolated germs were multi-drug resistant and bacteraemia was reported in 38%. Multivariate analyses for prediction of lethality found significant difference in SOFA score. Conclusions Mechanically ventilated CoViD-19 patients might frequently develop VAP. Longer ICU hospitalization was associated with pulmonary superinfection in the current cohort. Moreover, decreased minimal lung compliance was correlated to VAP and higher SOFA score at VAP diagnosis was associated with lethality.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Male
medicine.medical_specialty
030106 microbiology
Multi-drug resistant bacteria
Lung compliance
medicine.disease_cause
infectious diseases
Article
03 medical and health sciences
0302 clinical medicine
Intensive care
Internal medicine
Immunology and Microbiology(all)
Case fatality rate
medicine
Pneumonia, Bacterial
Humans
Severe acute respiratory syndrome coronavirus 2
Ventilator-associated pneumonia
Pharmacology (medical)
030212 general & internal medicine
Aged
Retrospective Studies
Ventilators, Mechanical
business.industry
Bacterial pneumonia
COVID-19
Pneumonia, Ventilator-Associated
Middle Aged
medicine.disease
bacterial infections and mycoses
Respiration, Artificial
respiratory tract diseases
Intensive Care Units
Superinfection
Cohort
SOFA score
Female
business
Coronavirus 2019 disease
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 14377780 and 1341321X
- Database :
- OpenAIRE
- Journal :
- Journal of Infection and Chemotherapy
- Accession number :
- edsair.doi.dedup.....55bea7858baadfbcec2e362e677fa168