Infecciones relacionadas con dispositivos invasivos después de cirugía cardiaca

Lerma, F. Álvarez; Armengol, Manel; Otal, J.J.; Palomar, Mercedes; Olaechea, Pedro; Peris, X.; Iglesias, Lorena Martín; Pellus, Anne; Arenzana, A.; Ballesteros, Juan

doi:10.1016/j.medin.2012.12.005

Cited by 6 publications

(9 citation statements)

References 18 publications

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“…También cabe destacar que el género femenino ha contraído ITU en un mayor porcentaje que el masculino coincidiendo, una vez más, con otros estudios 22 .…”

Section: Discussionunclassified

“…Aunque Lucet et al afirmaron que los pacientes con diabetes mellitus presentan una alta incidencia de colonización perineal por potenciales patógenos y la composición de su orina facilita el crecimiento de las bacterias 22 , nuestros datos no lo demuestran así, ya que únicamente el 10,3% de los pacientes diabéticos han resultado positivos en infección.…”

Section: Conclusionesunclassified

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Incidencia de la infección urinaria en pacientes postoperados de cirugía cardiaca: estudio comparativo según el dispositivo de sondaje

Fabrellas

Pavón

Canals

et al. 2015

Enfermería Intensiva

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“…También cabe destacar que el género femenino ha contraído ITU en un mayor porcentaje que el masculino coincidiendo, una vez más, con otros estudios 22 .…”

Section: Discussionunclassified

Section: Conclusionesunclassified

Incidencia de la infección urinaria en pacientes postoperados de cirugía cardiaca: estudio comparativo según el dispositivo de sondaje

Fabrellas

Pavón

Canals

et al. 2015

Enfermería Intensiva

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“…Moreover, only two studies were identi ed that compared VAP diagnostic algorithms [32,66]. HELICS was chosen as the reference standard due as it has been reported to have the best performance characteristics, is widely used internationally, and has been used as the reference standard for numerous other studies [2,[44][45][46][47]. CDC/NHSN and CPIS criteria were chosen as the other two most widely recognized and used criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, data comparing techniques head-to-head is lacking, thus we conducted a prospective non-randomized study to determine if in patients with VAP, does application of the Johanson VAP diagnosis was made independently by the treating clinical team. Diagnostic criteria were according to HELICS criteria [28] in accordance with in institutional standard and other published studies [2,[44][45][46][47]. Chest radiograph interpretation was undertaken "off-line" and by a team of 3 physicians (1 radiology, 1 critical care, 1 pulmonology) who were independent of the treating team.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Diagnostic Algorithms and Clinical Parameters to Diagnose Ventilator-Associated Pneumonia: A Prospective Observational Study

Rahimi–Bashar

Miller²,

Yaghoobi

et al. 2020

Preprint

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BACKGROUND: Suspicion and clinical criteria continue to serve as the foundation for ventilator-associated pneumonia (VAP) diagnosis, however the criteria used to diagnose VAP vary widely. Data from head-to-head comparisons of clinical diagnostic algorithms is lacking, thus a prospective observational study was performed to determine the performance characteristics of the Johanson criteria, Clinical Pulmonary Infection Score (CPIS), and Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN) criteria as compared to Hospital in Europe Link for Infection Control through Surveillance (HELICS) reference standard. METHODS: A prospective observational cohort study was performed in three mixed medical-surgical ICUs from one academic medical center from 1 October 2016 to 30 April 2018. VAP diagnostic criteria were applied to each patient including CDC/NHSN, CPIS, HELICS and Johanson criteria. Tracheal cultures and serum procalcitonin values were obtained for each patient. RESULTS: Eighty-five patients were enrolled (VAP 45, controls 41), mean age 46.94±18.9 years with a male predominance (72.94%). Using HELICS as the reference standard, the true positive (TP; sensitivity) and false negative (FN; miss rate) rates were CDC/NHSN (TP 44%; FN 0%), CPIS (TP 43%; FN 1%), Johnson (TP 43%; FN 1%). The highest true negative rate was seen with CPIS. CPIS had the highest Youden index; CDC/NHSN had the lowest. The positive tracheal culture rate was 81.2%. The sensitivity for positive tracheal culture with the serum procalcitonin level >0.5 ng/ml was 51.8%. CDC/NHSN had the highest false positive correlation with tracheal aspirate cultures. CONCLUSION: VAP remains a considerable source of morbidity and mortality in modern ICUs. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS displayed greater diagnostic accuracy compared to CDC/NHSN and Johanson criteria. Accuracy was improved with the addition of serum procalcitonin >0.5 ng/ml, but not positive quantitative endotracheal aspirate culture.TRIAL REGISTRATION: Not indicated for this study type.

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“…VAP diagnosis was made independently by the treating clinical team. Diagnostic criteria were according to HELICS criteria [35] in accordance with in institutional standard and other published studies [2,[58][59][60][61] as it is the de nition currently used in much of Europe, Australia, and the near-and middle east (including Iran). Chest radiograph interpretation was undertaken "off-line" and by a team of 3 physicians (1 radiology, 1 critical care, 1 pulmonology) who were independent of the treating team.…”

Section: Methodsmentioning

confidence: 99%

A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: A prospective observational study

Rahimi–Bashar

Miller

Yaghoobi

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUND: Suspicion and clinical criteria continue to serve as the foundation for ventilator-associated pneumonia (VAP) diagnosis, however the criteria used to diagnose VAP vary widely. Data from head-to-head comparisons of clinical diagnostic algorithms is lacking, thus a prospective observational study was performed to determine the performance characteristics of the Johanson criteria, Clinical Pulmonary Infection Score (CPIS), and Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN) criteria as compared to Hospital in Europe Link for Infection Control through Surveillance (HELICS) reference standard. METHODS: A prospective observational cohort study was performed in three mixed medical-surgical ICUs from one academic medical center from 1 October 2016 to 30 April 2018. VAP diagnostic criteria were applied to each patient including CDC/NHSN, CPIS, HELICS and Johanson criteria. Tracheal aspirate cultures (TAC) and serum procalcitonin values were obtained for each patient. RESULTS: Eighty-five patients were enrolled (VAP 44, controls 41). Using HELICS as the reference standard, the respective true positive rate (TPR; sensitivity), true negative rate (TNR; specificity), false positive rate (FPR; fall-out) and false negative rate (FNR; miss-rate) for each of the assessed diagnostic algorithms were: CDC/NHSN (Sensitivity 54.2%; Specificity 100%; FPR 95%; FNR 0%), CPIS (Sensitivity 68.75%; Specificity 95.23%; FPR 50%, FNR 2%), Johanson (Sensitivity 67.69%; Specificity 95%; FPR 52.5%, FNR 2%). The positive TAC rate was 81.2%. The sensitivity for positive TAC with the serum procalcitonin level >0.5 ng/ml was 51.8%. CONCLUSION: VAP remains a considerable source of morbidity and mortality in modern ICUs. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS had the greatest comparative diagnostic accuracy, whereas the sensitivity of the CDC/NHSN was only marginally better than a positive TAC plus serum procalcitonin >0.5 ng/ml. Algorithm accuracy was improved by adding serum procalcitonin >0.5 ng/ml, but not positive quantitative TAC.

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Infecciones relacionadas con dispositivos invasivos después de cirugía cardiaca

Cited by 6 publications

References 18 publications

Incidencia de la infección urinaria en pacientes postoperados de cirugía cardiaca: estudio comparativo según el dispositivo de sondaje

Incidencia de la infección urinaria en pacientes postoperados de cirugía cardiaca: estudio comparativo según el dispositivo de sondaje

A Comparison of Diagnostic Algorithms and Clinical Parameters to Diagnose Ventilator-Associated Pneumonia: A Prospective Observational Study

A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: A prospective observational study

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