Independent risk factors associated with hospital-acquired pneumonia in an adult ICU: 4-year prospective cohort study in a university reference hospital

Guzman-Herrador, Bernardo; Molina, C.; Allam, Mohamed Farouk; Navajas, Rafael Fernández-Crehuet

doi:10.1093/pubmed/fdv042

Cited by 26 publications

(28 citation statements)

References 15 publications

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“…Mechanical ventilation has been confirmed as an independent risk factor of nosocomial pneumonia because artificial airways are a serious risk factor for micro-aspirations [36]. This was the largest contributing factor for nosocomial infection in our study.…”

Section: Discussionsupporting

confidence: 66%

Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients

Zhou

et al. 2018

Respiratory Medicine

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Section: Discussionsupporting

confidence: 66%

Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients

Zhou

et al. 2018

Respiratory Medicine

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“…Compared with the Note: -, not detected severe group, the critical group had a signi cantly increased mortality. Recent studies related to COVID-19 reported that male was a risk factor for disease severity status, and age 65 or older was a risk factor related to death [3,17,18]. In our research, no differences in gender and age were found between the severe and critical groups.…”

Section: Discussioncontrasting

confidence: 52%

Etiology and Antimicrobial Resistance of Secondary Bacterial Infections in Patients Hospitalized With COVID-19 in Wuhan, China: A Retrospective Analysis

Li¹,

Wang

Yang

et al. 2020

Preprint

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Background: A considerable proportion of patients hospitalized with corona virus disease 2019 (COVID-19) have acquired secondary bacterial infections (SBIs). We report the etiology and antimicrobial resistance of bacteria to provide theoretical basis for appropriate infection therapy.Methods: In the retrospective study, we reviewed electronic medical records of all the patients hospitalized with COVID-19 in the Wuhan Union hospital from January 27 to March 17, 2020. According to the inclusion and exclusion criteria, patients who acquired SBIs were enrolled. Demographic, clinical course, etiology and antimicrobial resistance data of the SBIs were collected. Outcomes were also compared between patients who were classified as severe on admission and those who were classified as critical.Results: 6.8% (102/1495) of the patients with COVID-19 had acquired SBIs and almost half of them (50, 49.0%) died during hospitalization. Compared with the severe patients, the critical patients had a higher chance of SBIs. 159 strains of bacteria were isolated, 85.5% of which were Gram-negative bacteria. The top three bacteria of SBIs were A. baumannii (35.8%), K. pneumoniae (30.8%) and Staphylococcus (8.8%). The isolation rate of carbapenem-resistant A. baumannii and K. pneumoniae were 91.2% and 75.5%, respectively. Meticillin resistance was in 100% of Staphylococcus, and vancomycin resistance was not found. Conclusions: SBIs may occur in patients hospitalized with COVID-19 and lead to high mortality. The incidence of SBIs was associated with the grade on admission. Gram-negative bacteria, especially A. baumannii and K. pneumoniae, were the main bacteria and the resistance rates of the major isolated bacteria were generally high.

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“…By contrast, the presence of an inserted GT is considered as a significant risk factor, as seen from a recent large study of 4427 patients documenting that mechanical ventilation and the use of a GT were the most significant risk factors for the development of HAP (ref. 17 ). Apart from the insertion of a GT, patient immobility is a stronger risk factor for HAP than dysphagia, as shown by Brogan et al 18 .…”

Section: Discussionmentioning

confidence: 99%

Possibilities for modifying risk factors for the development of hospital-acquired pneumonia in intensive care patients: results of a retrospective, observational study

Uvizl¹,

Kolář²,

Herkel³

et al. 2017

BIOMED PAP

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Background. Hospital-acquired pneumonia (HAP) development is affected by a range of risk factors. Methods. A retrospective, observational study processing data on all consecutive intensive care patients older than 18 years of age between 1 January 2011 and 31 December 2015. The aim was to determine the incidence of potential risk factors and their impact on the development of HAP. Results. A total of 2229 patients. The overall mortality was 24.0%; the mean APACHE II score 21.4. The mean length of ICU stay was 5.9 days and the mean length of hospital stay was 20.5 days. The criteria for HAP were met by 310 patients (13.9%). Early-and late-onset HAP was diagnosed in 45 (14.5%) and 265 (85.5%) patients, respectively. The mean APACHE II score was 22.1, the mean length of ICU stay was 7.6 days and the mean length of hospital stay was 23.5 days. The most important non-modifiable factors increasing the risk of HAP were multiple organ failure (OR 13.733; P<0.0001), cardiac heart disease (OR 2.255; P<0.0001) and chronic renal failure (OR 2.194; P<0.002). The most common modifiable factors were intolerance to enteral nutrition (OR 3.055; P<0.0001), urgent tracheal intubation (OR 1.511; P<0.024), reintubation (OR 1.851; P<0.001), and bronchoscopy (OR 2.558; P<0.0001). Stress ulcer prophylaxis was administered to 83% of HAP patients and 68% of patients without HAP. Prophylaxis with famotidine was associated with a lower risk of HAP in 40.0% of patients (non-HAP in 49.9%), (OR 0.669; P=0.001) than prophylaxis with pentoprazol in 42.6% and 49.5% of patients, respectively (OR 0.756; P=0.027). Conclusions. Factors associated with the highest risk of the development of HAP can be determined. Pharmacological prophylaxis of gastric and duodenal stress ulcers was identified as an independent risk factor for HAP. The study was registered in the ClinicalTrials.gov database under the number NCT02779933.

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Independent risk factors associated with hospital-acquired pneumonia in an adult ICU: 4-year prospective cohort study in a university reference hospital

Cited by 26 publications

References 15 publications

Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients

Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients

Etiology and Antimicrobial Resistance of Secondary Bacterial Infections in Patients Hospitalized With COVID-19 in Wuhan, China: A Retrospective Analysis

Possibilities for modifying risk factors for the development of hospital-acquired pneumonia in intensive care patients: results of a retrospective, observational study

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