Microbial cause of ICU-acquired pneumonia: hospital-acquired pneumonia versus ventilator-associated pneumonia

Luyt, Charles‐Édouard; Hékimian, Guillaume; Koulenti, Despoina; Chastre, Jean

doi:10.1097/mcc.0000000000000526

Cited by 90 publications

(40 citation statements)

References 49 publications

(42 reference statements)

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“…The most common bacterial causes of VAP include Enterobacterales , Pseudomonas aeruginosa , Staphylococcus au reus, and Acinetobacter among the general population of mechanically ventilated patients [ 56 ]. The pathogens associated with VAP in ARDS are similar to those seen among non-ARDS patients who develop VAP (Fig.…”

Section: Epidemiology Of Nosocomial Pulmonary Infections In Ards Patimentioning

confidence: 99%

Pulmonary infections complicating ARDS

et al. 2020

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Section: Epidemiology Of Nosocomial Pulmonary Infections In Ards Patimentioning

confidence: 99%

Pulmonary infections complicating ARDS

et al. 2020

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“…Although not detected in the PLF samples analyzed, within this class, Staphylococcus imposes a major health burden on healthcare systems. Staphylococci are a problem in surgical site infections and ventilatorassociated infections, which makes them the second most common causative agents of hospital-acquired infections [46][47][48]. Vancomycin-resistant and methicillin-resistant S. aureus strains are extremely difficult to treat and need immediate attention.…”

Section: Iron Chelation In Casp-induced Sepsismentioning

confidence: 99%

Comparison of Treatment Effects of Different Iron Chelators in Experimental Models of Sepsis

Lehmann

Aali

Holbein

2021

Life

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Growing evidence indicates that dysregulated iron metabolism with altered and excess iron availability in some body compartments plays a significant role in the course of infection and sepsis in humans. Given that all bacterial pathogens require iron for growth, that iron withdrawal is a normal component of innate host defenses and that bacterial pathogens have acquired increasing levels of antibiotic resistance, targeting infection and sepsis through use of appropriate iron chelators has potential to provide new therapeutics. We have directly compared the effects of three Food and Drug Administration (FDA)-approved chelators (deferoxamine—DFO; deferiprone—DFP; and deferasirox—DFX), as were developed for treating hematological iron overload conditions, to DIBI, a novel purpose-designed, anti-infective and anti-inflammatory water-soluble hydroxypyridinone containing iron-selective copolymers. Two murine sepsis models, endotoxemia and polymicrobial abdominal sepsis, were utilized to help differentiate anti-inflammatory versus anti-infective activities of the chelators. Leukocyte adhesion, as measured by intravital microscopy, was observed in both models, with DIBI providing the most effective reduction and DFX the poorest. Inflammation in the abdominal sepsis model, assessed by cytokine measurements, indicated exacerbation by DFX and DFO for plasma Interleukin (IL)-6 and reductions to near-control levels for DIBI and DFP. Peritoneal infection burden was reduced 10-fold by DIBI while DFX and DFP provided no reductions. Overall, the results, together with those from other studies, revealed serious limitations for each of the three hematological chelators, i.e., as potentially repurposed for treating infection/sepsis. In contrast, DIBI provided therapeutic benefits, consistent with various in vitro and in vivo results from other studies, supporting the potential for its use in treating sepsis.

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“…Also, P. aeruginosa is responsible for approximately 4% total cases of hospital-acquired bloodstream infections, and was the third leading cause among Gram-negative pathogens [ 5 ]. Nosocomial pneumonia, especially the ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in critically ill patients, and the isolation of P. aeruginosa is associated with worse clinical outcomes [ 6 , 7 ]. P. aeruginosa is also known to cause a wide variety of other infections, encompassing all organs of the human body, including soft tissue infection in burns, open wounds and postsurgery; urinary tract infection associated with the use of urinary catheter; foot infection in diabetics and individuals with impaired microvascular circulation; ear infection, especially otitis externa and chronic suppurative otitis media associated with tissue injury and water blockage; and keratitis associated with extended contact lens wear and contaminated contact lens [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

et al. 2021

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Driven in part by its metabolic versatility, high intrinsic antibiotic resistance, and a large repertoire of virulence factors, Pseudomonas aeruginosa is expertly adapted to thrive in a wide variety of environments, and in the process, making it a notorious opportunistic pathogen. Apart from the extensively studied chronic infection in the lungs of people with cystic fibrosis (CF), P. aeruginosa also causes multiple serious infections encompassing essentially all organs of the human body, among others, lung infection in patients with chronic obstructive pulmonary disease, primary ciliary dyskinesia and ventilator-associated pneumonia; bacteremia and sepsis; soft tissue infection in burns, open wounds and postsurgery patients; urinary tract infection; diabetic foot ulcers; chronic suppurative otitis media and otitis externa; and keratitis associated with extended contact lens use. Although well characterized in the context of CF, pathogenic processes mediated by various P. aeruginosa virulence factors in other organ systems remain poorly understood. In this review, we use an organ system-based approach to provide a synopsis of disease mechanisms exerted by P. aeruginosa virulence determinants that contribute to its success as a versatile pathogen.

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Microbial cause of ICU-acquired pneumonia: hospital-acquired pneumonia versus ventilator-associated pneumonia

Abstract: When selecting initial antimicrobial therapy in patients with HAP/VAP, more attention should be paid to individual risk factors for MDR pathogens, severity of the clinical situation, and the local epidemiology than to the type of pneumonia.

Cited by 90 publications

References 49 publications

Pulmonary infections complicating ARDS

Pulmonary infections complicating ARDS

Comparison of Treatment Effects of Different Iron Chelators in Experimental Models of Sepsis

An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

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