Co-Infection and Ventilator-Associated Pneumonia in Critically Ill COVID-19 Patients Requiring Mechanical Ventilation: A Retrospective Cohort Study

Sarton, Benjamine; Grare, Marion; Vardon‐Bounes, Fanny; Gaubert, Anna; Silva, Stein; Crognier, Laure; Riu, Béatrice; Seguin, Thierry; Georges, Bernard; Minville, Vincent; Ruiz, Stéphanie

doi:10.3390/biomedicines10081952

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…These authors also notes a higher frequency of pulmonary co-infections in patients admitted for influenza pneumonia: 33.6% [ 5 ] and 25% [ 17 ]. In the study by Sarton et al [ 18 ], the difference between the two populations was less important (16% for SARS-CoV-2 pneumonia and 33% for influenza pneumonia) but all patients included in this study were on mechanical ventilation for at least 48 h.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Background: Few data are available on the impact of bacterial pulmonary co-infection (RespCoBact) during COVID-19 (CovRespCoBact). The aim of this study was to compare the prognosis of patients admitted to an ICU for influenza pneumonia and for SARS-CoV-2 pneumonia with and without RespCoBact. Methods: This was a multicentre (n = 11) observational study using the Outcomerea© database. Since 2008, all patients admitted with influenza pneumonia or SARS-CoV-2 pneumonia and discharged before 30 June 2021 were included. Risk factors for day-60 death and for ventilator-associated-pneumonia (VAP) in patients with influenza pneumonia or SARS-CoV-2 pneumonia with or without RespCoBact were determined. Results: Of the 1349 patients included, 157 were admitted for influenza and 1192 for SARS-CoV-2. Compared with the influenza patients, those with SARS-CoV-2 had lower severity scores, were more often under high-flow nasal cannula, were less often under invasive mechanical ventilation, and had less RespCoBact (8.2% for SARS-CoV-2 versus 24.8% for influenza). Day-60 death was significantly higher in patients with SARS-CoV-2 pneumonia with no increased risk of mortality with RespCoBact. Patients with influenza pneumonia and those with SARS-CoV-2 pneumonia had no increased risk of VAP with RespCoBact. Conclusions: SARS-CoV-2 pneumonia was associated with an increased risk of mortality compared with Influenza pneumonia. Bacterial pulmonary co-infections on admission were not associated with patient survival rates nor with an increased risk of VAP.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Recurrent ventilator-associated pneumonia in severe Covid-19 ARDS patients requiring ECMO support

Collado-Lledó,

Moyon,

Chommeloux

et al. 2024

Ann. Intensive Care

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Objective To describe ventilator-associated pneumonia (VAP) recurrence in COVID-19 patients requiring extracorporeal membrane oxygenation (ECMO) support, and to evaluate the impact of antimicrobial treatment duration of the first VAP episode on VAP recurrence. Methods Adult patients with COVID-19 severe pneumonia on ECMO admitted between March 2020 and January 2022 were retrospectively included. Primary outcome was incidence of VAP recurrence, and secondary outcome was the impact of duration of antimicrobial treatment on VAP recurrence. Results Among the 252 included patients, 226 (90%) developed a first VAP. Sixteen had lung abscess and were excluded, leaving 210 patients. VAP recurrence occurred in 172 patients (82%), with a median (IQR) time from first VAP to recurrence of 10 (7–13) days. Pseudomonas aeruginosa and Enterobacteriaceae were respectively responsible for 28% and 52% of first VAP, and 51% and 62% of first recurrence episodes. Among the 210 patients with a first VAP, 158 (75%) received a short course of antibiotics [< 8 days, median (IQR) duration 6 (5–7) days] and 52 (25%) received a prolonged course of antibiotics [≥ 8 days, median (IQR) duration 9 (8–10) days]. Estimated cumulative incidence of VAP recurrence, taking into account death and extubation as competing risks, was not different in patients with short– and prolonged–antimicrobial treatment. Conclusions In patients with severe Covid-19–ARDS requiring ECMO support, VAP recurrence occurs frequently, with Enterobacteriaceae and Pseudomonas aeruginosa as predominant causative microorganisms. An antimicrobial treatment of ≥ 8 days for the treatment of first VAP episode did not reduce the risk of VAP recurrence, as compared to shorter duration.

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Ventilator-Associated Pneumonia Among Patients With Covid-19: A Systematic Review

Bartoszewicz,

Nadolny

et al. 2023

Emerg Med Serv

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The aim of this study is to investigate the characteristics, epidemiology, and the diagnostic criteria for VAP used most often among patients with COVID-19. PubMed, Embase, Scopus, and Google Scholar were searched between December 2019 and 1 July 2023 with the keywords ventilator-associated pneumonia, COVID-19, VAP, VAP in COVID-19, pneumonia, coronavirus, and SARS-CoV-2. Retrospective and prospective studies, case reports, and randomized controlled trial (RCT) of adults with conf i rmed cases of COVID-19 and VAP were selected for further analysis. Sixty-nine studies with 21,627 patients were included. The occurrence of VAP with COVID-19 ranged from 6%–91%; the mortality of patients with VAP with COVID-19 was 0%–100%. The dif f erence between the ranges is wide owing to dif f erences in study settings and VAP diagnostic criteria used. The bacterial strains responsible for infection were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter species, and Staphylococcus aureus. The percentage of pneumonia associated with multidrug-resistant bacteria varied from 4% to 76%. Most studies were conducted in Europe. The diagnostic criterion used for VAP most often was that of the European Centre for Disease Prevention and Control. CTo reduce the incidence and mortality of VAP, it is crucial to create new empiric antibiotic therapy guidelines and place a focus on adopting VAP prophylaxis in the intensive care unit.

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Co-Infection and Ventilator-Associated Pneumonia in Critically Ill COVID-19 Patients Requiring Mechanical Ventilation: A Retrospective Cohort Study

Cited by 3 publications

References 29 publications

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

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

Recurrent ventilator-associated pneumonia in severe Covid-19 ARDS patients requiring ECMO support

Ventilator-Associated Pneumonia Among Patients With Covid-19: A Systematic Review

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