Future Directions and Molecular Basis of Ventilator Associated Pneumonia

Aykaç, Kübra; Özsürekçi, Yasemin; Başaranoğlu, Sevgen Tanır

doi:10.1155/2017/2614602

Cited by 10 publications

(10 citation statements)

References 94 publications

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“…Undoubtedly, the occurrence of VAP in a patient treated in ICUs significantly worsens the prognosis, increases the costs of treatment, and prolongs the time of hospitalization [5,10,11]. The purpose of the study is a retrospective assessment of risk factors of VAP in patients hospitalized in intensive care units.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Pneumonia Associated with Mechanical Ventilation

Kózka

Sega

Wojnar-Gruszka

et al. 2020

IJERPH

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Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5-15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi 2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

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Section: Introductionmentioning

confidence: 99%

Risk Factors of Pneumonia Associated with Mechanical Ventilation

Kózka

Sega

Wojnar-Gruszka

et al. 2020

IJERPH

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“…Elementos estruturantes das bactérias, como flagelo, fímbrias e polissacarídeos, tornam o processo de adesão mais ágil e preciso. No epitélio do sistema respiratório, levam a adesão e, em alguns casos, a consecutiva infecção 10 22 .…”

Section: Fisiopatologiaunclassified

Pneumonia Bacteriana: Aspectos Epidemiológicos, Fisiopatologia E Avanços No Diagnóstico

Assunção¹,

Pereira²,

Abreu³

2018

RIB

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A pneumonia é uma doença infecciosa que atinge os alvéolos pulmonares, ocasionada, principalmente, por bactérias, vírus, fungos e parasitas. Dentre as principais bactérias, Haemophilus influenzae, Klebsiella pneumonia, Streptococcus pneumoniae, Staphylococcus aureus e as do grupo das Gram-negativas não fermentadoras de glicose, a exemplo de Acinetobacter spp. e Pseudomonas aeruginosa, são as mais isoladas. Estima-se que 450 milhões de casos de pneumonia ocorram por ano em todo o mundo e o Brasil é protagonista na lista dos países com maior número de casos. Pacientes que fazem uso de ventilação mecânica têm até 21 vezes mais chances de desenvolver a doença e 20% daqueles que utilizam a técnica por mais de 48 horas desenvolverão a infecção. Desta forma, esta revisão teve por objetivo fazer uma avaliação crítica sistematizada da literatura sobre a doença, aspectos epidemiológicos, fisiopatologia e avanços no diagnóstico. Este estudo observou que houve uma evolução nos métodos de diagnóstico, resultando na diminuição expressiva do número de mortes. No entanto, para que a queda no número de acometidos se mantenha, a correta prescrição e utilização da antibioticoterapia são imprescindíveis.

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“…VAP is frequently caused by Gram-negative aerobic bacteria [4][5][6], such as Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter spp; while Staphylococcus aureus is the most frequent Gram-positive pathogen [7]. In addition, the VAP can be polymicrobial, which complicates diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Assessment of a Loop-Mediated Isothermal Amplification (LAMP) Assay for the Rapid Detection of Pathogenic Bacteria from Respiratory Samples in Patients with Hospital-Acquired Pneumonia

et al. 2020

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Rapid identification of the causative agent of hospital-acquired pneumonia (HAP) will allow an earlier administration of a more appropriate antibiotic and could improve the outcome of these patients. The aim of this study was to develop a rapid protocol to identify the main microorganisms involved in HAP by loop-mediated isothermal amplification (LAMP) directly from respiratory samples. First of all, a rapid procedure (<30 min) to extract the DNA from bronchoalveolar lavage (BAL), endotracheal aspirate (EA) or bronchoaspirate (BAS) was set up. A specific LAMP for Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii was performed with the extracted solution at 65 °C for 30–40 min. Overall, 58 positive BAL and 83 EA/BAS samples were tested. The limits of detection varied according to the microorganism detected. Validation of the LAMP assay with BAL samples showed that the assay was 100% specific and 86.3% sensitive (positive predictive value of 100% and a negative predictive value of 50%) compared with culture. Meanwhile for BAS/EA samples, the assay rendered the following statistical parameters: 100% specificity, 94.6% sensitivity, 100% positive predictive value and 69.2% negative predictive value. The turnaround time including sample preparation and LAMP was circa 1 h. LAMP method may be used to detect the most frequent bacteria causing HAP. It is a simple, cheap, sensitive, specific and rapid assay.

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Future Directions and Molecular Basis of Ventilator Associated Pneumonia

Cited by 10 publications

References 94 publications

Risk Factors of Pneumonia Associated with Mechanical Ventilation

Risk Factors of Pneumonia Associated with Mechanical Ventilation

Pneumonia Bacteriana: Aspectos Epidemiológicos, Fisiopatologia E Avanços No Diagnóstico

Assessment of a Loop-Mediated Isothermal Amplification (LAMP) Assay for the Rapid Detection of Pathogenic Bacteria from Respiratory Samples in Patients with Hospital-Acquired Pneumonia

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