Ventilator-associated pneumonia in critically ill patients with COVID-19
| العنوان: | Ventilator-associated pneumonia in critically ill patients with COVID-19 |
|---|---|
| المؤلفون: | Josefin Bartholdson Scott, Amelia Solderholm, Janine Lux, Joana Pereira-Dias, Sally Forrest, Delphine Cuchet-Lourenço, Stephen Baker, Surendra Parmar, Nicholas M. Brown, Razeen Mahroof, Gordon Dougan, Ellen Higginson, Andrew Conway Morris, Fahad A Khokhar, Sapna Sharma-Hajela, Martin D. Curran, Sushmita Sridhar, Islam Hamed, Vilas Navapurkar, Laura Heales, Benjamin Ravenhill, Mailis Maes |
| المساهمون: | Conway Morris, Andrew [0000-0002-3211-3216], Apollo - University of Cambridge Repository |
| المصدر: | Critical Care Critical Care, Vol 25, Iss 1, Pp 1-11 (2021) |
| بيانات النشر: | BioMed Central, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Lung microbiome, Secondary infection, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, Nosocomial infections, medicine, Molecular diagnostics, Humans, Ventilator-associated pneumonia, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Incidence (epidemiology), Research, Hazard ratio, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Pneumonia, Ventilator-Associated, COVID-19, 030208 emergency & critical care medicine, Retrospective cohort study, lcsh:RC86-88.9, Middle Aged, medicine.disease, Intensive care unit, 3. Good health, respiratory tract diseases, Pneumonia, Intensive Care Units, Critical care, Female, business |
| الوصف: | Background Pandemic COVID-19 caused by the coronavirus SARS-CoV-2 has a high incidence of patients with severe acute respiratory syndrome (SARS). Many of these patients require admission to an intensive care unit (ICU) for invasive ventilation and are at significant risk of developing a secondary, ventilator-associated pneumonia (VAP). Objectives To study the incidence of VAP and bacterial lung microbiome composition of ventilated COVID-19 and non-COVID-19 patients. Methods In this retrospective observational study, we compared the incidence of VAP and secondary infections using a combination of microbial culture and a TaqMan multi-pathogen array. In addition, we determined the lung microbiome composition using 16S RNA analysis in a subset of samples. The study involved 81 COVID-19 and 144 non-COVID-19 patients receiving invasive ventilation in a single University teaching hospital between March 15th 2020 and August 30th 2020. Results COVID-19 patients were significantly more likely to develop VAP than patients without COVID (Cox proportional hazard ratio 2.01 95% CI 1.14–3.54, p = 0.0015) with an incidence density of 28/1000 ventilator days versus 13/1000 for patients without COVID (p = 0.009). Although the distribution of organisms causing VAP was similar between the two groups, and the pulmonary microbiome was similar, we identified 3 cases of invasive aspergillosis amongst the patients with COVID-19 but none in the non-COVID-19 cohort. Herpesvirade activation was also numerically more frequent amongst patients with COVID-19. Conclusion COVID-19 is associated with an increased risk of VAP, which is not fully explained by the prolonged duration of ventilation. The pulmonary dysbiosis caused by COVID-19, and the causative organisms of secondary pneumonia observed are similar to that seen in critically ill patients ventilated for other reasons. |
| وصف الملف: | application/pdf; text/xml |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::13db352a6118c8bbc244ccba4b3b3cbf https://www.repository.cam.ac.uk/handle/1810/319523 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....13db352a6118c8bbc244ccba4b3b3cbf |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |