| Title: |
Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study |
| Authors: |
Rouze, Anahita; Martin-Loeches, I.; Povoa, P.; Makris, D.; Artigas, A.; Bouchereau, Mathilde; Lambiotte, F.; Metzelard, M.; Cuchet, P.; Boulle Geronimi, C.; Labruyere, M.; Tamion, F.; Nyunga, M.; Luyt, C. E.; Labreuche, Julien; Pouly, O.; Bardin, J.; Saade, A.; Asfar, P.; Baudel, J. L.; Beurton, A.; Garot, D.; Ioannidou, I.; Kreitmann, L.; Llitjos, J. F.; Magira, E.; Mégarbane, B.; Meguerditchian, D.; Moglia, E.; Mekontso-Dessap, A.; Reignier, J.; Turpin, M.; Pierre, Alexandre; Plantefeve, G.; Vinsonneau, C.; Floch, P. E.; Weiss, N.; Ceccato, A.; Torres, A.; Duhamel, Alain; Nseir, Saad |
| Contributors: |
Université de Lille; CHU Lille; Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 UGSF; Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576; METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694; Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 RID-AGE; Evaluation des technologies de santé et des pratiques médicales - ULR 2694 METRICS |
| Publication Year: |
2024 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
SARS-CoV-2; COVID-19; Ventilator-associated pneumonia; Ventilator-associated tracheobronchitis; Critical illness |
| Description: |
Purpose Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI. Methods Multicenter retrospective European cohort performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 h were eligible if they had: SARS-CoV-2 pneumonia, influenza pneumonia, or no viral infection at ICU admission. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. All VA-LRTI were prospectively identified, and chest-X rays were analyzed by at least two physicians. Cumulative incidence of first episodes of VA-LRTI was estimated using the Kalbfleisch and Prentice method, and compared using Fine-and Gray models. Results 1576 patients were included (568 in SARS-CoV-2, 482 in influenza, and 526 in no viral infection groups). VA-LRTI incidence was significantly higher in SARS-CoV-2 patients (287, 50.5%), as compared to influenza patients (146, 30.3%, adjusted sub hazard ratio (sHR) 1.60 (95% confidence interval (CI) 1.26 to 2.04)) or patients with no viral infection (133, 25.3%, adjusted sHR 1.7 (95% CI 1.2 to 2.39)). Gram-negative bacilli were responsible for a large proportion (82% to 89.7%) of VA-LRTI, mainly Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp. Conclusions The incidence of VA-LRTI is significantly higher in patients with SARS-CoV-2 infection, as compared to patients with influenza pneumonia, or no viral infection after statistical adjustment, but residual confounding may still play a role in the effect estimates. ; 47 |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
1c04b40a-1f14-40b1-bef0-b4e87498d300; Intensive Care Medicine; Intensive Care Med; http://hdl.handle.net/20.500.12210/90460 |
| Availability: |
https://hdl.handle.net/20.500.12210/90460 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.EBA73EEB |
| Database: |
BASE |