Early Onset Pneumonia

Bronchard, Régis; Albaladéjo, Pierre; Brezac, Gilles; Geffroy, Arnaud; Seince, Pierre-François; Morris, William P.; Branger, Catherine; Marty, J

doi:10.1097/00000542-200402000-00009

Cited by 165 publications

(59 citation statements)

References 29 publications

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“…Furthermore, our study expands these results to phagocytosis of live S. aureus, which is a predominant pathogen, especially in patients with brain trauma (9,10). More important, the results indicate substantial differences between the two barbiturates thiopentone and methohexitone with respect to their inhibitory potency and a differential pattern of inhibition.…”

Section: Discussionsupporting

confidence: 64%

Dose-dependent influence of barbiturates but not of propofol on human leukocyte phagocytosis of viable Staphylococcus aureus

Ploppa

Kiefer

Nohé

et al. 2006

Critical Care Medicine

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Our in vitro model points at substantially different effects of barbiturates and propofol on phagocytosis of S. aureus, which is one of the most important pathogens in patients who need neuroprotective therapy. The inhibitory effects of both barbiturates demonstrate a strong dose-dependency, with more pronounced effects for methohexitone. Impairment of phagocytosis activity was more pronounced than granulocyte recruitment.

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Section: Discussionsupporting

confidence: 64%

Dose-dependent influence of barbiturates but not of propofol on human leukocyte phagocytosis of viable Staphylococcus aureus

Ploppa

Kiefer

Nohé

et al. 2006

Critical Care Medicine

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“…In this population, pneumonia usually occurs within the first four days of mechanical ventilation and is termed early-onset pneumonia (EO-VAP) [1]. The incidence of EO-VAP ranges from 21 to 60% [2, 3] in critically ill patients with traumatic brain injury (TBI) and is about 48% in those with subarachnoid hemorrhage. In a mixed population of patients in coma due to various causes, EO-VAP accounted for 70% of all cases of pneumonia [4].…”

Section: Introductionmentioning

confidence: 99%

Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis

Righy

Brasil

Vallès

et al. 2017

Ann. Intensive Care

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BackgroundEarly-onset ventilator-associated pneumonia (EO-VAP) is the leading cause of morbidity and mortality in comatose patients. However, VAP prevention bundles focus mainly on late-onset VAP and may be less effective in preventing EO-VAP in comatose patients. Systemic antibiotic administration at the time of intubation may have a role in preventing EO-VAP. Therefore, we evaluated the effectiveness of systemic antibiotic administration in VAP prevention in comatose patients through a systematic review and meta-analysis. MethodsWe searched for studies published through December 2015 that evaluated systemic antibiotic prophylaxis in comatose patients. Two authors independently selected and evaluated full-length reports of randomized clinical trials or prospective cohorts in patients aged >16 years that evaluated the impact of systemic antibiotics at the time of intubation on EO-VAP compared to placebo or no prophylaxis. The outcome variables were the incidence of EO-VAP, the duration of mechanical ventilation, ICU length of stay, and ICU mortality. ResultsWe identified 10,988 citations, yielding 26 articles for further analysis; three studies with 267 patients were finally analyzed. Most patients (n = 135) were comatose due to head trauma. Systemic antibiotic administration was associated with decreased incidence of EO-VAP (RR 0.32; 95% CI 0.19–0.54) and shorter ICU LOS (standardized mean difference −0.32; 95% CI −0.56 to −0.08), but had no effect on mortality (RR 1.03; 95% CI 0.7–1.53) or duration of mechanical ventilation (standardized mean difference −0.16; 95% CI −0.41 to 0.08). ConclusionsAntibiotic prophylaxis in comatose patients reduced the incidence of EO-VAP and decreased the ICU stay slightly. Future trials are needed to confirm these results.

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“…Among infections, pneumonia (PN) is a major cause of morbimortality [6], [7]. We [8] and others [9] have reported that methicillin-susceptible Staphylococcus aureus (MSSA) is the main pathogen involved in post-traumatic PN. A marked depression of cell-mediated immune function, known as post-traumatic immune suppression (IS), plays a role in sepsis after severe trauma [10].…”

Section: Introductionmentioning

confidence: 99%

CpG-ODN and MPLA Prevent Mortality in a Murine Model of Post-Hemorrhage-Staphyloccocus aureus Pneumonia

Roquilly

Gautreau²,

Segain³

et al. 2010

PLoS ONE

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Infections are the most frequent cause of complications in trauma patients. Post-traumatic immune suppression (IS) exposes patients to pneumonia (PN). The main pathogen involved in PN is Methicillin Susceptible Staphylococcus aureus (MSSA). Dendritic cells () may be centrally involved in the IS. We assessed the consequences of hemorrhage on pneumonia outcomes and investigated its consequences on DCs functions. A murine model of hemorrhagic shock with a subsequent MSSA pneumonia was used. Hemorrhage decreased the survival rate of infected mice, increased systemic dissemination of sepsis and worsened inflammatory lung lesions. The mRNA expression of Tumor Necrosis Factor-alpha (TNF-α), Interferon-beta (IFN-β) and Interleukin (IL)-12p40 were mitigated for hemorrhaged-mice. The effects of hemorrhage on subsequent PN were apparent on the pDCs phenotype (reduced MHC class II, CD80, and CD86 molecule membrane expression). In addition, hemorrhage dramatically decreased CD8+ cDCs- and CD8- cDCs-induced allogeneic T-cell proliferation during PN compared with mice that did not undergo hemorrhage. In conclusion, hemorrhage increased morbidity and mortality associated with PN; induced severe phenotypic disturbances of the pDCs subset and functional alterations of the cDCs subset. After hemorrhage, a preventive treatment with CpG-ODN or Monophosphoryl Lipid A increased transcriptional activity in DCs (TNF-α, IFN-β and IL-12p40) and decreased mortality of post-hemorrhage MSSA pneumonia.

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Early Onset Pneumonia

Cited by 165 publications

References 29 publications

Dose-dependent influence of barbiturates but not of propofol on human leukocyte phagocytosis of viable Staphylococcus aureus

Dose-dependent influence of barbiturates but not of propofol on human leukocyte phagocytosis of viable Staphylococcus aureus

Systemic antibiotics for preventing ventilator-associated pneumonia in comatose patients: a systematic review and meta-analysis

CpG-ODN and MPLA Prevent Mortality in a Murine Model of Post-Hemorrhage-Staphyloccocus aureus Pneumonia

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