Document detail
ID
doi:10.1186/s13613-023-01207-9...
Author
Laurichesse, Guillaume Schwebel, Carole Buetti, Niccolò Neuville, Mathilde Siami, Shidasp Cohen, Yves Laurent, Virginie Mourvillier, Bruno Reignier, Jean Goldgran‐Toledano, Dany Ruckly, Stéphane Montmollin, Etienne Souweine, Bertrand Timsit, Jean‐François Dupuis, Claire for the OUTCOME R. E. A. networkLangue
enEditor
Springer
Category
Medicine & Public Health
Year
2023
listing date
11/1/2023
Keywords
= 0 48 h imv 95% ahr = 1 [ci risk patients influenza covid-19 < 0 vap 01 associated ventilated mortalityAbstract
Background Data on ventilator associated pneumonia (VAP) in COVID-19 and influenza patients admitted to intensive care units (ICU) are scarce.
This study aimed to estimate day-60 mortality related to VAP in ICU patients ventilated for at least 48 h, either for COVID-19 or for influenza, and to describe the epidemiological characteristics in each group of VAP.
Design Multicentre retrospective observational study.
Setting Eleven ICUs of the French OutcomeRea^™ network.
Patients Patients treated with invasive mechanical ventilation (IMV) for at least 48 h for either COVID-19 or for flu.
Results Of the 585 patients included, 503 had COVID-19 and 82 had influenza between January 2008 and June 2021.
A total of 232 patients, 209 (41.6%) with COVID-19 and 23 (28%) with influenza, developed 375 VAP episodes.
Among the COVID-19 and flu patients, VAP incidences for the first VAP episode were, respectively, 99.2 and 56.4 per 1000 IMV days ( p < 0.01), and incidences for all VAP episodes were 32.8 and 17.8 per 1000 IMV days ( p < 0.01).
Microorganisms of VAP were Gram-positive cocci in 29.6% and 23.5% of episodes of VAP ( p < 0.01), respectively, including Staphylococcus aureus in 19.9% and 11.8% ( p = 0.25), and Gram-negative bacilli in 84.2% and 79.4% ( p = 0.47).
In the overall cohort, VAP was associated with an increased risk of day-60 mortality (aHR = 1.77 [1.36; 2.30], p < 0.01), and COVID-19 had a higher mortality risk than influenza (aHR = 2.22 [CI 95%, 1.34; 3.66], p < 0.01).
VAP was associated with increased day-60 mortality among COVID-19 patients (aHR = 1.75 [CI 95%, 1.32; 2.33], p < 0.01), but not among influenza patients (aHR = 1.75 [CI 95%, 0.48; 6.33], p = 0.35).
Conclusion The incidence of VAP was higher in patients ventilated for at least 48 h for COVID-19 than for influenza.
In both groups, Gram-negative bacilli were the most frequently detected microorganisms.
In patients ventilated for either COVID-19 or influenza VAP and COVID-19 were associated with a higher risk of mortality.
Laurichesse, Guillaume,Schwebel, Carole,Buetti, Niccolò,Neuville, Mathilde,Siami, Shidasp,Cohen, Yves,Laurent, Virginie,Mourvillier, Bruno,Reignier, Jean,Goldgran‐Toledano, Dany,Ruckly, Stéphane,Montmollin, Etienne,Souweine, Bertrand,Timsit, Jean‐François,Dupuis, Claire,for the OUTCOME R. E. A. network, 2023, Mortality, incidence, and microbiological documentation of ventilated acquired pneumonia (VAP) in critically ill patients with COVID-19 or influenza, Springer
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