Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

Koulenti, Despoina; Lisboa, Thiago; Brun‐Buisson, Christian; Krueger, Wolfgang A.; Macor, Antonio; Solé‐Violán, Jordi; Dı́az, Emili; Topeli, Arzu; Waele, Jan J. De; Carneiro, Antônio Fernando; Martín‐Loeches, Ignacio; Armaganidis, Apostolos; Rello, Jordi

doi:10.1097/ccm.0b013e3181a037ac

Cited by 194 publications

(137 citation statements)

References 33 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…Organizational aspects of the study are described elsewhere. 27 All patients who were admitted to the ICU for treatment of pneumonia or received invasive mechanical ventilation V entilator-associated pneumonia (VAP) remains the most frequent nosocomial infection among intensive care unit (ICU) patients. The rate of VAP depends on the risk profile of the index patient population and the duration of mechanical ventilation (exposure time).…”

Section: Methodsmentioning

confidence: 99%

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

Blot

Llauradó-Serra²,

Koulenti³

et al. 2010

American Journal of Critical Care

View full text Add to dashboard Cite

Objective To determine how the patient to nurse ratio affects risk for ventilator-associated pneumonia. Methods Data from an earlier study in 27 intensive care units in 9 European countries were examined in a secondary analysis. The initial cohort included 2585 consecutive patients who had mechanical ventilation (1) after admission for treatment of pneumonia or (2) for more than 48 hours irrespective of the diagnosis at admission. In units with variable staffing levels, the highest patient to nurse ratio in a 24-hour period was considered. Patients from 6 units that did not provide data on nurse staffing levels were excluded from the analysis. Results Ventilator-associated pneumonia developed in 393 of the 1658 patients (23.7%) in the secondary cohort. In units with patient to nurse ratios of 1 to 1, 2 to 1, 2.5 to 1, and 3 to 1, rates were 9.3%, 25.7%, 18.7%, and 24.2%, respectively (P = .003). Rates were significantly lower (P = .002) in units with a ratio of 1 to 1 (9.3%) than in units with a ratio of more than 1 patient to 1 nurse (24.4%). After adjustments for confounding covariates, ratios of more than 1 patient to 1 nurse were no longer associated with increased risk for ventilator-associated pneumonia. Conclusions A patient to nurse ratio of 1 to 1 appears to be associated with a lower risk for ventilator-associated pneumonia, but after adjustments for confounding covariates, the difference is not significant.

show abstract

Section: Methodsmentioning

confidence: 99%

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

Blot

Llauradó-Serra²,

Koulenti³

et al. 2010

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…has a great role in the infections such as pneumonia, bacteremia, urinary tract infections, and meningitis. These bacteria are resistant to various antibiotics and can be transmitted from patient to patient; hence, it is difficult to treat and eradicate it (11,21).…”

Section: Discussionmentioning

confidence: 99%

“…HAP is one of the deadliest nosocomial infections, which has a great economic burden for patients and health system (10). Mechanical ventilation increases the risk of pneumonia (11). HAP can be diagnosed by finding organisms with bronchoscopy or aspiration.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Pneumonia in Patients Admitted to the Intensive Care Unit of a Tertiary Care Center in Mashhad, Northeast of Iran; an Etiologic Survey

Farid

Moghaddam

Bojdy

2018

Arch Clin Infect Dis

View full text Add to dashboard Cite

Background: Hospital-acquired pneumonia (HAP) prevalence is related to patients' population and diagnostic methods. HAP incidence is reported in different studies from 9% to 46%. The current study aimed at evaluating the etiology of HAP in patients admitted to intensive care units (ICUs). Methods:The patients admitted to ICU of Imam Reza hospital (a tertiary care and teaching hospital in Mashhad, Northeast of Iran) were evaluated for HAP based on the following criteria: fever, leukocytosis, purulent discharge, new radiologic findings, changes in O2 saturation, and ventilator setting. Blood and endotracheal aspirates cultures were performed for all patients. Demographic characteristics were recorded in a checklist. Results: Among the 88 adult patients enrolled in the current study, the most frequent radiologic finding was patchy infiltration in

show abstract

“…For prevention of these infections, we should promote our infection control measures, respiratory care practices, and hygienic conditions. Moreover, several studies have showed that age of the patient and duration of mechanical ventilation are important risk factors for the development of NIs (11)(12)(13) . Similarly, the present study showed a negative correlation between age and NI and a positive correlation between duration of mechanical ventilation and NI.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Properties, Pathogens, and Mortality-Related Risk Factors of Nosocomial Infections in Pediatric Cardiovascular Surgery Intensive Care Unit

Karaağaç¹

2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

Introduction:The aim of this study was to evaluate the properties, pathogens, mortality-related risk factors, and mortality rates of nosocomial infections (NIs) in the pediatric cardiovascular surgery intensive care unit. Patients and Methods:The files of 838 children, aged 0-16 years, who underwent cardiovascular surgery between January, 2014 and January, 2016 in Kartal Koşuyolu Research Hospital were evaluated in this retrospective study. NI was diagnosed according to the Center for Disease Control criteria. The correlations between several risk factors and NI were statistically analyzed.Results: Fifty-four children out of 838 (6.4%) had NI. 29 of them (53.9%) had respiratory tract infections, 14 (24.8%) had urinary tract infections, 8 (15.7%) had bacteremia and 3 (5.6%) had wound site infections. The isolated pathogens were Klebsiella pneumoniae (20.4%), Pseudomonas aeruginosa (18.6%), Candida albicans (18.6%), Stenotrophomonas maltophilia (13.8%), Acinetobacter baumannii (10.5%), coagulasenegative staphylococci (9.1%), methicillin-resistant Staphylococcus aureus (MRSA, 3.6%), Serratia marcescens (1.8%), Citrobacter freundii (1.8%), and Providencia rettgeri (1.8%). The mortality rate due to NI was 13.7% (11/80). There was a statistically significant relationship between NIs and age and duration of mechanic ventilation (p< 0.05), but not between NIs and gender, accompanying abnormalities, and nasogastric feeding (p> 0.05). Conclusion:Gram-negative bacteria were the most common pathogens of NI, which caused mortality. Assessing the responsible pathogens and determining the risk factors will help us to develop effective infection control measures for reducing the morbidity and mortality rates.

show abstract

Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

Abstract: Etiological diagnosis of nosocomial pneumonia in a large sample of European intensive care units was based mainly on noninvasive techniques. However, there was high variability in bronchoscopy use between the participating intensive care units.

Cited by 194 publications

References 33 publications

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

Nosocomial Pneumonia in Patients Admitted to the Intensive Care Unit of a Tertiary Care Center in Mashhad, Northeast of Iran; an Etiologic Survey

Evaluation of Properties, Pathogens, and Mortality-Related Risk Factors of Nosocomial Infections in Pediatric Cardiovascular Surgery Intensive Care Unit

Contact Info

Product

Resources

About