European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI

Autor segons l'article: Martin-Loeches, Ignacio; Reyes, Luis Felipe; Nseir, Saad; Ranzani, Otavio; Povoa, Pedro; Diaz, Emili; Schultz, Marcus J; Rodriguez, Alejandro H; Serrano-Mayorga, Cristian C; De Pascale, Gennaro; Navalesi, Paolo; Panigada, Mauro; Coelho, Luis Miguel; Skoczynski, Szymon; Esperatti, Mariano; Cortegiani, Andrea; Aliberti, Stefano; Caricato, Anselmo; Salzer, Helmut J F; Ceccato, Adrian; Civljak, Rok; Soave, Paolo Maurizio; Luyt, Charles-Edouard; Ekren, Pervin Korkmaz; Rios, Fernando; Masclans, Joan Ramon; Marin, Judith; Iglesias-Moles, Silvia; Nava, Stefano; Chiumello, Davide; Bos, Lieuwe D; Artigas, Antoni; Froes, Filipe; Grimaldi, David; Taccone, Fabio Silvio; Antonelli, Massimo; Torres, Antoni

Departament: Ciències Mèdiques Bàsiques

Autor/s de la URV: Rodríguez Oviedo, Alejandro Hugo

Paraules clau: Ventilator-associated pneumonia; Vat; Vap; Va-lrti; Tracheobronchitis; Sepsis ic; Sepsis; Mortality; Management; Intensive-care; Guidelines; Diagnosis; Criteri; Acquired pneumonia

Resum: PurposeLower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcomes.MethodsA prospective observational study was conducted in 13 countries over two continents from 9th May 2016 until 16th August 2019. Characteristics and outcomes of ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), ICU hospital-acquired pneumonia (ICU-HAP), HAP that required invasive ventilation (VHAP), and HAP in patients transferred to the ICU without invasive mechanical ventilation were collected. The clinical diagnosis and treatments were per clinical practice and not per protocol. Descriptive statistics were used to compare the study groups.Results1060 patients with LRTI (72.5% male sex, median age 64 [50-74] years) were included in the study; 160 (15.1%) developed VAT, 556 (52.5%) VAP, 98 (9.2%) ICU-HAP, 152 (14.3%) HAP, and 94 (8.9%) VHAP. Patients with VHAP had higher serum procalcitonin (PCT) and Sequential Organ Failure Assessment (SOFA) scores. Patients with VAP or VHAP developed acute kidney injury, acute respiratory distress syndrome, multiple organ failure, or septic shock more often. One thousand eight patients had microbiological samples, and 711 (70.5%) had etiological microbiology identified. The most common microorganisms were Pseudomonas aeruginosa (18.4%) and Klebsiella spp (14.4%). In 382 patients (36%), the causative pathogen shows some antimicrobial resistance pattern. ICU, hospital and 28-day mortality were 30.8%, 37.5% and 27.5%, respectively. Patients with VHAP had the highest ICU, in-hospital and 28-day mortality rates.ConclusionVHAP patients presented the highest mortality among those admitted to the ICU. Multidrug-resistant pathogens frequently cause nosocomial LRTI in this multinational cohort study.

Àrees temàtiques: Saúde coletiva; Odontología; Nutrição; Medicina iii; Medicina ii; Medicina i; Interdisciplinar; General medicine; Farmacia; Engenharias iv; Enfermagem; Emergency medicine & critical care; Educação física; Critical care medicine; Critical care and intensive care medicine; Ciências biológicas iii; Ciências biológicas ii; Ciências biológicas i

Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/

Adreça de correu electrònic de l'autor: alejandrohugo.rodriguez@urv.cat

Data d'alta del registre: 2025-01-27

Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion

Enllaç font original: https://link.springer.com/article/10.1007/s00134-023-07210-9

Referència a l'article segons font original: Intensive Care Medicine. 49 (10): 1212-1222

Referència de l'ítem segons les normes APA: Martin-Loeches, Ignacio; Reyes, Luis Felipe; Nseir, Saad; Ranzani, Otavio; Povoa, Pedro; Diaz, Emili; Schultz, Marcus J; Rodriguez, Alejandro H; Serra (2023). European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI. Intensive Care Medicine, 49(10), 1212-1222. DOI: 10.1007/s00134-023-07210-9

URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/

DOI de l'article: 10.1007/s00134-023-07210-9

Entitat: Universitat Rovira i Virgili

Any de publicació de la revista: 2023

Tipus de publicació: Journal Publications