Bacterial Pulmonary Co-Infections on ICU Admission: Comparison in Patients with SARS-CoV-2 and Influenza Acute Respiratory Failure: A Multicentre Cohort Study

Delhommeau, Grégoire; Buetti, Niccolò; Neuville, Mathilde; Siami, Shidasp; Cohen, Yves; Laurent, Virginie; Mourvillier, Bruno; Reignier, Jean; Goldgran-Tolédano, Dany; Schwebel, Carole; Ruckly, Stéphane; Montmollin, Étienne de; Souweine, Bertrand; Timsit, Jean François; Dupuis, Claire

doi:10.3390/biomedicines10102646

Cited by 4 publications

(8 citation statements)

References 32 publications

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“…In a multicenter study including 1349 patients, Delhommeau et al [ 36 ] found significantly higher mortality at day 60 in patients with CP compared to IP. In accordance with our data, the mortality risk did not increase due to c/s.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Co- or Superinfection in Patients Treated in Intensive Care Unit with COVID-19- and Influenza-Associated Pneumonia

et al. 2023

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Viral pneumonia is frequently complicated by bacterial co- or superinfection (c/s) with adverse effects on patients’ outcomes. However, the incidence of c/s and its impact on the outcomes of patients might be dependent on the type of viral pneumonia. We performed a retrospective observational study in patients with confirmed COVID-19 pneumonia (CP) or influenza pneumonia (IP) from 01/2009 to 04/2022, investigating the incidence of c/s using a competing risk model and its impact on mortality in these patients in a tertiary referral center using multivariate logistic regressions. Co-infection was defined as pulmonary pathogenic bacteria confirmed in tracheal aspirate or bronchoalveolar lavage within 48 h after hospitalization. Superinfection was defined as pulmonary pathogenic bacteria detected in tracheal aspirate or bronchoalveolar lavage 48 h after hospitalization. We examined 114 patients with CP and 76 patients with IP. Pulmonary bacterial co-infection was detected in 15 (13.2%), and superinfection was detected in 50 (43.9%) of CP patients. A total of 5 (6.6%) co-infections (p = 0.2269) and 28 (36.8%) superinfections (p = 0.3687) were detected in IP patients. The overall incidence of c/s did not differ between CP and IP patients, and c/s was not an independent predictor for mortality in a study cohort with a high disease severity. We found a significantly higher probability of superinfection for patients with CP compared to patients with IP (p = 0.0017).

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Section: Discussionmentioning

confidence: 99%

Bacterial Co- or Superinfection in Patients Treated in Intensive Care Unit with COVID-19- and Influenza-Associated Pneumonia

et al. 2023

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“…Most of our data came from retrospective research, and there might have been selection bias. Of the 35 articles we included, only 5 articles 15,19,26,33,34 clearly noted that there was no cross-infection between the two types of patients, and other articles did not elaborate on this. Vaccination has a great influence on the severity and prognosis of COVID-19 patients and influenza patients, but unfortunately, none of the studies we included described the vaccination status of patients in detail.…”

Section: Limitationsmentioning

confidence: 99%

Comparison of Clinical Characteristics and Outcomes in Intensive Care Units Between Patients with Coronavirus Disease 2019 (COVID-19) and Patients with Influenza: A Systematic Review and Meta-Analysis

Zhong,

Wang,

Guo

et al. 2024

J Intensive Care Med

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Background Severe infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or influenza virus can cause patients to be admitted to intensive care units (ICUs). It is necessary to understand the differences in clinical characteristics and outcomes between these two types of critically ill patients. Methods We searched Embase, PubMed, and Web of Science for articles and performed a meta-analysis using Stata 14.0 with a random-effects model. This paper was written in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Thirty-five articles involving 131,692 ICU patients with coronavirus disease 2019 (COVID-19) and 30,286 ICU patients with influenza were included in our meta-analysis. Compared with influenza patients, COVID-19 patients were more likely to be male (odds ratio (OR) = 1.75, 95% CI: 1.54-1.99) and older (standardized mean difference (SMD) = 0.16, 95% CI: 0.03-0.29). In terms of laboratory test results, COVID-19 patients had higher lymphocyte (SMD = 0.38, 95% CI: 0.17-0.59) and platelet counts (SMD = 0.52, 95% CI: 0.29-0.75) but lower creatinine (SMD = −0.29, 95% CI: −0.55-0.03) and procalcitonin levels (SMD = −0.78, 95% CI: −1.11-0.46). Diabetes (SMD = 1.27, 95% CI: 1.08-1.48) and hypertension (SMD = 1.30, 95% CI: 1.05-1.60) were more prevalent in COVID-19 patients, while influenza patients were more likely to have cancer (OR = 0.52, 95% CI: 0.44-0.62), cirrhosis (OR = 0.52, 95% CI: 0.44-0.62), immunodepression (OR = 0.38, 95% CI: 0.25-0.58), and chronic pulmonary diseases (OR = 0.35, 95% CI: 0.24-0.52). We also found that patients with COVID-19 had longer ICU stays (SMD = 0.20, 95% CI: 0.05-0.34), were more likely to develop acute respiratory distress syndrome (OR = 4.90, 95% CI: 2.77-8.64), and had higher mortality (OR = 1.35, 95% CI: 1.17-1.55). Conclusions There are some differences in the basic characteristics, comorbidities, laboratory test results and complications between ICU patients with COVID-19 and ICU patients with influenza. Critically ill patients with COVID-19 often require more medical resources and have worse clinical outcomes. PROSPERO Registration Number: CRD42023452238

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“…Although this is a well-established definition used in the literature, differentiating between bacterial coinfection and colonialization is not always possible. Nonetheless, both bacterial coinfections and colonialization at time of intubation have been shown to be associated with a higher mortality depending on the documented pathogen and the number of comorbidities [11]. In regard to VAP, we counted bacterial superinfection more than 48 h after intubation as VAP according to the literature [17,18].…”

Section: Microbiological Screeningmentioning

confidence: 99%

“…Previous studies investigated the prevalence of coinfection of SARS-CoV-2 patients and influenza patients upon hospital admission. Delhommeau et al showed that bacterial coinfection in SARS-CoV-2 patients was less frequent than in patients with influenza (8.2% for SARS-CoV-2 versus 24.8% for influenza) [11]. Furthermore, the prevalence of coinfection was not associated with a higher mortality or with the development of VAP [11].…”

Section: Introductionmentioning

confidence: 99%

“…Delhommeau et al showed that bacterial coinfection in SARS-CoV-2 patients was less frequent than in patients with influenza (8.2% for SARS-CoV-2 versus 24.8% for influenza) [11]. Furthermore, the prevalence of coinfection was not associated with a higher mortality or with the development of VAP [11]. Concerning VAP alone, the overall incidence of VAPs in Europe has been declining over the past decade.…”

Section: Introductionmentioning

confidence: 99%

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Influence of a Structured Microbiological Endotracheal Monitoring Program on the Outcome of Critically Ill COVID-19 Patients: An Observational Study

Dibos,

Haschka,

Abbassi

et al. 2023

JCM

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Background: In past influenza pandemics and the current COVID-19 pandemic, bacterial endotracheal superinfections are a well-known risk factor for higher morbidity and mortality. The goal of this study was to investigate the influence of a structured, objective, microbiological monitoring program on the prognosis of COVID-19 patients with mechanical ventilation. Methods: A structured microbiological monitoring program (at intubation, then every 3 days) included collection of endotracheal material. Data analysis focused on the spectrum of bacterial pathogens, mortality, as well as intensive care unit (ICU), hospital, and mechanical ventilation duration. Results: A total of 29% of the patients showed bacterial coinfection at the time of intubation, and within 48 h, 56% developed ventilator-associated pneumonia (VAP). Even though patients with VAP had significantly longer ICU, hospital, and mechanical ventilation durations, there was no significant difference in mortality between patients with VAP pneumonia and patients without bacterial infection. Conclusion: VAP is a common complication in COVID-19 patients. In contrast to already published studies, in our study implementing a structured microbiological monitoring program, COVID-19 patients with bacterial coinfection or VAP did not show higher mortality. Thus, a standardized, objective, microbiological screening can help detect coinfection and ventilator-associated infections, refining anti-infective therapy and positively influencing patient outcomes.

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Bacterial Pulmonary Co-Infections on ICU Admission: Comparison in Patients with SARS-CoV-2 and Influenza Acute Respiratory Failure: A Multicentre Cohort Study

Cited by 4 publications

References 32 publications

Bacterial Co- or Superinfection in Patients Treated in Intensive Care Unit with COVID-19- and Influenza-Associated Pneumonia

Bacterial Co- or Superinfection in Patients Treated in Intensive Care Unit with COVID-19- and Influenza-Associated Pneumonia

Comparison of Clinical Characteristics and Outcomes in Intensive Care Units Between Patients with Coronavirus Disease 2019 (COVID-19) and Patients with Influenza: A Systematic Review and Meta-Analysis

Influence of a Structured Microbiological Endotracheal Monitoring Program on the Outcome of Critically Ill COVID-19 Patients: An Observational Study

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