Ventilator-associated pneumonia in critically ill patients with COVID-19.
Ventilator-associated pneumonia in critically ill patients with COVID-19.
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DOI：
10.1186/s13054-021-03460-5
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发表时间：
2021-01-11
期刊：
影响因子：
--
通讯作者：
Conway Morris A
中科院分区：
文献类型：
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作者：
Maes M;Higginson E;Pereira-Dias J;Curran MD;Parmar S;Khokhar F;Cuchet-Lourenço D;Lux J;Sharma-Hajela S;Ravenhill B;Hamed I;Heales L;Mahroof R;Soderholm A;Forrest S;Sridhar S;Brown NM;Baker S;Navapurkar V;Dougan G;Bartholdson Scott J;Conway Morris A
由冠状病毒 SARS-CoV-2 引起的大流行性 COVID-19 严重急性呼吸综合征（SARS）患者的发病率很高。其中许多患者需要入住重症监护病房 (ICU) 进行有创通气，并且存在发生继发性呼吸机相关性肺炎 (VAP) 的巨大风险。研究通气 COVID-19 和非 COVID-19 患者的 VAP 发生率和细菌肺微生物组组成。 在这项回顾性观察研究中，我们结合微生物培养和 TaqMan 多病原体芯片比较了 VAP 和继发感染的发生率。此外，我们还使用 16S RNA 分析确定了一组样本中的肺部微生物组组成。该研究涉及 2020 年 3 月 15 日至 2020 年 8 月 30 日期间在同一所大学教学医院接受有创通气的 81 名 COVID-19 患者和 144 名非 COVID-19 患者。与未患 COVID 的患者相比，COVID-19 患者发生 VAP 的可能性显着更高（Cox 比例风险比 2.01 95% CI 1.14–3.54，p = 0.0015）。对于没有 COVID 的患者，呼吸机使用密度为 28/1000 天，而没有使用呼吸机天数的密度为 13/1000 (p = 0.009)。尽管两组之间引起 VAP 的微生物分布相似，并且肺部微生物组相似，但我们在 COVID-19 患者中发现了 3 例侵袭性曲霉菌病病例，但在非 COVID-19 队列中没有发现一例。在 COVID-19 患者中，疱疹病毒激活的频率也更高。 COVID-19 与 VAP 风险增加有关，但通气持续时间延长并不能完全解释这一点。 COVID-19引起的肺部生态失调以及观察到的继发性肺炎的病原体与因其他原因通气的危重患者中观察到的相似。
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). To study the incidence of VAP and bacterial lung microbiome composition of ventilated COVID-19 and non-COVID-19 patients. 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. 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. 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.
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影响因子：
3.5
作者：
Cheng K;He M;Shu Q;Wu M;Chen C;Xue Y
通讯作者：
Xue Y
影响因子：
11.8
作者：
Kalil, Andre C.;Metersky, Mark L.;Brozek, Jan L.
通讯作者：
Brozek, Jan L.
DOI：
10.1016/j.cmi.2020.07.041
发表时间：
2021-01
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Garcia-Vidal C;Sanjuan G;Moreno-García E;Puerta-Alcalde P;Garcia-Pouton N;Chumbita M;Fernandez-Pittol M;Pitart C;Inciarte A;Bodro M;Morata L;Ambrosioni J;Grafia I;Meira F;Macaya I;Cardozo C;Casals C;Tellez A;Castro P;Marco F;García F;Mensa J;Martínez JA;Soriano A;COVID-19 Researchers Group
通讯作者：
COVID-19 Researchers Group
影响因子：
64.8
作者：
Carvelli, Julien;Demaria, Olivier;Vivier, Eric
通讯作者：
Vivier, Eric
影响因子：
38.9
作者：
Plachouras D;Lepape A;Suetens C
通讯作者：
Suetens C