TY - JOUR
T1 - Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study
AU - Giacobbe, Daniele Roberto
AU - Battaglini, Denise
AU - Enrile, Elisa Martina
AU - Dentone, Chiara
AU - Vena, Antonio
AU - Robba, Chiara
AU - Ball, Lorenzo
AU - Bartoletti, Michele
AU - Coloretti, Irene
AU - Di Bella, Stefano
AU - Di Biagio, Antonio
AU - Brunetti, Iole
AU - Mikulska, Malgorzata
AU - Carannante, Novella
AU - De Maria, Andrea
AU - Magnasco, Laura
AU - Maraolo, Alberto Enrico
AU - Mirabella, Michele
AU - Montrucchio, Giorgia
AU - Patroniti, Nicolò
AU - Taramasso, Lucia
AU - Tiseo, Giusy
AU - Fornaro, Giacomo
AU - Fraganza, Fiorentino
AU - Monastra, Luca
AU - Roman-Pognuz, Erik
AU - Paluzzano, Giacomo
AU - Fiorentino, Giuseppe
AU - Corcione, Antonio
AU - Bussini, Linda
AU - Pascale, Renato
AU - Corcione, Silvia
AU - Tonetti, Tommaso
AU - Rinaldi, Matteo
AU - Falcone, Marco
AU - Biagioni, Emanuela
AU - Ranieri, Vito Marco
AU - Giannella, Maddalena
AU - De Rosa, Francesco Giuseppe
AU - Girardis, Massimo
AU - Menichetti, Francesco
AU - Viale, Pierluigi
AU - Pelosi, Paolo
AU - Bassetti, Matteo
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/2/2
Y1 - 2021/2/2
N2 - The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
AB - The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
KW - Coronavirus
KW - COVID-19
KW - SARS-CoV-2
KW - VAP
KW - Ventilation
UR - http://www.scopus.com/inward/record.url?scp=85118319554&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85118319554&partnerID=8YFLogxK
U2 - 10.3390/jcm10040555
DO - 10.3390/jcm10040555
M3 - Article
AN - SCOPUS:85118319554
VL - 10
SP - 1
EP - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
SN - 2077-0383
IS - 4
M1 - 555
ER -