Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients

But, Ayşe; Yetkin, Meltem Arzu; Kanyılmaz, Dilek; Aslaner, Hümeyra; Baştuğ, Aliye; Aypak, Adalet; Öngürü, Pınar; Akıncı, Esragül; Mutlu, Nevzat Mehmet; Bodur, Hürrem

doi:10.3906/sag-1601-38

Cited by 30 publications

(36 citation statements)

References 20 publications

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“…A mortalidade bruta geral na UTI durante o estudo foi de 34,55%. Um estudo retrospectivo realizado na Turquia em UTI clínica e cirúrgica geral, com 417 pacientes, apontou uma mortalidade bruta de 39,8% nos pacientes com pneumonia associada à ventilação mecânica (17) . Istosugere o fato de que pacientes oncológicos não apresentam mortalidade significativamente superior quando comparados a pacientes internados emUTIs de especialidades diferentes.…”

Section: Discussionunclassified

<b> Perfil dos pacientes admitidos em uma unidade de Terapia Intensiva Oncológica/ Profile of patients admitted in a oncological Intensive Therapy Unit

Cunha¹,

Cunha²,

Santos³

et al. 2018

Cienc. Cuid. Saúde

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Este estudo objetiva analisar o perfil dos pacientes admitidos em uma unidade de terapia intensiva oncológica. Trata-se de um estudo descritivo de abordagem quantitativa. A coleta de dados foi realizada no período de setembro a dezembro de 2016, através de sistema informatizado utilizado pela instituição. Foram admitidos 55 pacientes durante o período da coleta. A idade variou entre 18 e 80 anos, com média de 55 anos. Em sua maioria, são pacientes com neoplasias gastrointestinais (29,09%), provenientes das enfermarias do hospital (32,73%). No geral, 14,55% receberam cuidados paliativos e a mortalidade total no período foi de 34,55%. A carga de trabalho apresentada foi de 79,04%, traduzida em uma demanda de trabalho de 18 horas e 57 minutos. Houve predomínio do Karnofsky Performance Status 30% (52,73%) e de pacientes com Índice de Comorbidade de Charlson entre 2 e 5 pontos (76,36%). As unidades de terapia intensiva oncológica devem estar preparadas para atuar com pacientes sem possibilidades de cura. A mortalidade não é superior quando comparada a unidades de terapia intensiva de outras especialidades, desmistificando a admissão de pacientes oncológicos em unidades de terapia intensiva.

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Section: Discussionunclassified

<b> Perfil dos pacientes admitidos em uma unidade de Terapia Intensiva Oncológica/ Profile of patients admitted in a oncological Intensive Therapy Unit

Cunha¹,

Cunha²,

Santos³

et al. 2018

Cienc. Cuid. Saúde

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“…A. baumannii is the most common nosocomial pathogen that causes bloodstream infections (BSI) or ventilator-associated pneumonia (VAP) in many medical centers, particularly in Turkey (2, 5). Carbapenem resistance rates exceed 90% in some parts of the World (3).…”

Section: Discussionmentioning

confidence: 99%

“…Eravacycline is a novel fluorocycline that belongs to the tetracycline class of antimicrobials may be a treatment option for CRAB (5). In vitro studies were shown that eravacycline minimum inhibitory concentrations (MICs) were found to be 2-8 fold lower than tigecycline MICs against CRAB (6–8).…”

Section: Introductionmentioning

confidence: 99%

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

Özger

Çuhadar

Yıldız

et al. 2019

Preprint

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26The synergistic activity of eravacycline in combination with colistin on carbapenem-resistant 27 A.baumannii (CRAB) isolates was evaluated in this study. Minimum inhibitory 28 concentrations (MICs) of eravacycline and colistin were determined by the broth 29 microdilution method. MICs values ranged between 1 to 4 mg and 0,5 to 128 mg/L for 30 eravacycline and colistin, respectively. In-vitro synergy between eravacycline and colistin 31 was evaluated by using the chequerboard methodology. Synergistic activity was found in 10 32 % of the strains, and additive effect in 20 %. No antagonism was detected. Similar activity 33 was also observed in colistin resistant CRAB isolates. The result of this study indicates that 34 eravacycline and colistin combination may be a potential therapeutic option for the treatment 35 of CRAB related infections. (CRAB) is an important nosocomial 53 pathogen causing substantial morbidity and mortality (1, 2). Current treatment options 54 (polymyxins, tigecycline, aminoglycosides) for CRAB are limited and suffer from 55 pharmacokinetic limitations such as high toxicity and low plasma levels (3). Therefore, to 56 enhance clinical efficacy and to avoid toxicity, combination therapy is often used for CRAB 57 infections (4). 58Eravacycline is a novel fluorocycline that belongs to the tetracycline class of 59 antimicrobials may be a treatment option for CRAB (5). In vitro studies were shown that 60 eravacycline minimum inhibitory concentrations (MICs) were found to be 2-8 fold lower 61 than tigecycline MICs against CRAB (6-8). The drug is also active against colistin resistant 62 strains (9). Despite in vitro activity, treatment success of eravacycline in CRAB infections are 63 unknown due to lack of clinical trials (10, 11). Management of healthcare-associated 64 infections (HCAI) caused by CRAB should be required combination therapy. There is no in 65 vitro study related to the synergism of eravacycline with other antibiotics in the literature. 66The aim of this in vitro study is to evaluate the synergistic activity of eravacycline in 67 combination with colistin on CRAB isolates. 68 Results 69Ten carbapenem-resistant A. baumannii strains were used in this study. Three of these 70 strains were also resistant to colistin. All isolates were found to have bla OXA-51 and nine 71 harbored bla OXA-23. The characteristics of 10 CRAB isolates included in chequerboard 72 experiments were shown in Table 1. 73MIC values ranged between 1 to 4 mg and 0,5 to 128 mg/L for eravacycline and 74 colistin, respectively. Chequerboard analysis showed 10% synergy, 20% additive, 70% 132This research received no specific grant from any funding agency in the public, commercial, 133 or not-for-profit sectors.

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“…The increasing prevalence of VAP in recent years has made VAP -related health risks a global concern. The incidence rates of VAP in the United States, Europe, Latin America, and Asia Paci c were 13.50%, 19.40%, 13.80%, and 16.00% respectively in a prospective observational study (P = 0.04) [6].The mortality rate of VAP is high, ranging from 14.00% to 44.40%, and can reach 78.00% in speci c settings [8][9][10][11][12]. VAP was shown to prolong the ICU length of stay and increase the risk of death in critically ill patients [13].…”

Section: Introductionmentioning

confidence: 96%

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A meta-analysis.

Wang

Jia

et al. 2020

Preprint

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Background: Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However, the incidence rates, risk factors and mortality rates of VAP are controversial.Methods: The Web of Science, EMBASE, PubMed and Cochrane Library databases through May 2020 were independently searched by two researchers to collect all relevant studies. Data including incidence rates, risk factors and mortality rates of VAP were extracted for the meta-analysis.Results: 24 studies, including 10 retrospective studies and 14 prospective studies on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 20/1000 ventilator-days (95% confidence interval (CI) 17–22%). The data demonstrated that trauma (odds ratio (OR) 1.51; 95% CI 1.21-1.88), steroids use (OR 1.51; 95% CI 1.25-1.82), enteral feeding (OR 3.40; 95% CI 2.56-4.52), nasogastric tube placement (OR 2.96; 95% CI 1.75-5.00), tracheostomy (OR 3.65; 95% CI 1.93-6.90), reintubation (OR 6.08; 95% CI 4.62-8.00), central vascular catheter (CVC) placement (OR 3.83; 95% CI 2.55-5.77), blood transfusion(OR 1.75; 95% CI 1.16-2.64), H2 blockers use (OR 2.28; 95% CI 1.27-4.07) and Chronic obstructive pulmonary disease(COPD)(OR 1.24; 95% CI 1.07-1.44) were risk factors of VAP. When patients developed VAP, duration of ICU stay (OR 11.09; 95% CI 7.50-14.68) and duration of mechanical ventilation (MV) (OR 12.96; 95% CI 10.42-15.51) were significantly increased. What’s more, VAP was associated with an increased risk of mortality (OR 1.38; 95% CI 1.04-1.83).ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.

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Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients

Cited by 30 publications

References 20 publications

<b> Perfil dos pacientes admitidos em uma unidade de Terapia Intensiva Oncológica/ Profile of patients admitted in a oncological Intensive Therapy Unit

<b> Perfil dos pacientes admitidos em uma unidade de Terapia Intensiva Oncológica/ Profile of patients admitted in a oncological Intensive Therapy Unit

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A meta-analysis.

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