A Systematic Review and Meta-analysis of Ventilator-associated Pneumonia in Adults in Asia: An Analysis of National Income Level on Incidence and Etiology.
A Systematic Review and Meta-analysis of Ventilator-associated Pneumonia in Adults in Asia: An Analysis of National Income Level on Incidence and Etiology.
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DOI：
10.1093/cid/ciy543
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发表时间：
2019-01-18
期刊：
影响因子：
--
通讯作者：
Nadjm B
中科院分区：
文献类型：
--
作者：
Bonell A;Azarrafiy R;Huong VTL;Viet TL;Phu VD;Dat VQ;Wertheim H;van Doorn HR;Lewycka S;Nadjm B
呼吸机相关性肺炎（VAP）是重症监护中最常见的医院获得性感染（HAI）。在亚洲，VAP越来越多地由耐药革兰氏阴性菌引起。尽管全球面临着抗生素耐药性危机，但亚洲VAP的流行病学记录很少。我们系统回顾了1990年1月1日至2017年8月17日期间在奥维德Medline、Embase Classic和Embase上发表的文献，以估计VAP的发病率、患病率和病因。我们进行了一项荟萃分析，以提供汇总率和按国家收入水平划分的比率。VAP的合并发病密度在低收入和中高收入国家较高，在高收入国家较低（分别为18.5、15.2和9.0/1000呼吸机日）。鲍曼不动杆菌（n = 3687 [26%]）和铜绿假单胞菌（n = 3176 [22%]）是VAP的主要原因;金黄色葡萄球菌引起14%（n = 1999）。碳青霉烯类耐药率为57.1%。VAP仍然是HAI的常见原因，特别是在低收入和中等收入国家，抗生素耐药性很高。呼吸机相关性肺炎（VAP）是重症监护中最常见的感染。我们的系统回顾和荟萃分析发现，与亚洲高收入国家相比，低收入国家的VAP发病率最高。抗菌素耐药率也高得惊人。
Ventilator-associated pneumonia (VAP) is the commonest hospital-acquired infection (HAI) in intensive care. In Asia, VAP is increasingly caused by resistant gram-negative organisms. Despite the global antimicrobial resistance crisis, the epidemiology of VAP is poorly documented in Asia. We systematically reviewed literature published on Ovid Medline, Embase Classic, and Embase from 1 January 1990 to 17 August 2017 to estimate incidence, prevalence, and etiology of VAP. We performed a meta-analysis to give pooled rates and rates by country income level. Pooled incidence density of VAP was high in lower- and upper-middle-income countries and lower in high-income countries (18.5, 15.2, and 9.0 per 1000 ventilator-days, respectively). Acinetobacter baumannii (n = 3687 [26%]) and Pseudomonas aeruginosa (n = 3176 [22%]) were leading causes of VAP; Staphylococcus aureus caused 14% (n = 1999). Carbapenem resistance was common (57.1%). VAP remains a common cause of HAI, especially in low- and middle-income countries, and antibiotic resistance is high. Ventilator-associated pneumonia (VAP) is the commonest infection in intensive care. Our systematic review and meta-analysis found VAP incidence rates to be highest in low-income compared with high-income countries in Asia. Antimicrobial resistance rates are also alarmingly high.
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影响因子：
4.9
作者：
Lagamayo, Evelina N.
通讯作者：
Lagamayo, Evelina N.
影响因子：
3.7
作者：
Ding C;Zhang Y;Yang Z;Wang J;Jin A;Wang W;Chen R;Zhan S
通讯作者：
Zhan S
DOI：
10.1186/cc13775
发表时间：
2014-03-18
期刊：
Critical care (London, England)
影响因子：
--
作者：
Kalanuria AA;Ziai W;Mirski M
通讯作者：
Mirski M
影响因子：
1.7
作者：
Denys, Gerald A.;Relich, Ryan F.
通讯作者：
Relich, Ryan F.
影响因子：
168.9
作者：
Allegranzi, Benedetta;Nejad, Sepideh Bagheri;Pittet, Didier
通讯作者：
Pittet, Didier