Ventilator-associated pneumonia in intensive care units in Hubei Province, China: a multicentre prospective cohort survey

Xie, De; Xiong, Wei; Lai, Rui-ping; Liu, Li; Gan, Xiumin; Wang, Xiaohui; Wang, Min; Lou, Yuan-xia; Fu, Xiang-yun; Wang, Hui‐Fang; Xiang, Hao; Xu, Yu; Nie, Shaoping

doi:10.1016/j.jhin.2011.03.009

Cited by 54 publications

(54 citation statements)

References 25 publications

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“…Likewise, in our study, we found data similar to INICC, with 82.5% of MRSA [9]. In addition, the second most common pathogen was Acinetobacter baumanni, which is possibly increasing because ICU patients are administered with a variety of broad-spectrum antibiotics and as a consequence of inadequate resistant control measures [4].…”

Section: Discussionsupporting

confidence: 81%

“…Ventilator-associated pneumonia (VAP) has been reported to be the most serious health care-associated infection (HAI), as the leading cause of morbidity and mortality for device-associated infections (DAIs), particularly in the intensive care unit (ICU) setting [1][2][3][4]. The mortality attributable to VAP has been shown to exceed 10% [5].…”

Section: Introductionmentioning

confidence: 99%

“…However, in limited-resource countries, the importance of measuring the ICU patient infection risks, outcomes, and processes remains underrecognized many times [2,11], and very few analyses have been performed to show the impact of interventions on the VAP rate, which would serve as guidance for tackling this problem [2]. Likewise, study heterogeneity in developing countries may hinder the underlying causes of excessive variation in the reported rates [2,4].…”

Section: Introductionmentioning

confidence: 99%

“…Through the implementation of the INICC program, it was demonstrated that there was a notable difference in the DA-HAI rates between the ICUs of hospitals from the industrialized world and those from limited-resource health care settings, with rates ranging from 3 to 5 times higher [3,4,13,14].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: Findings of the International Nosocomial Infection Control Consortium

Tao¹,

Hu²,

Rosenthal³

et al. 2012

Journal of Critical Care

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: Findings of the International Nosocomial Infection Control Consortium

Tao¹,

Hu²,

Rosenthal³

et al. 2012

Journal of Critical Care

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“…The main risk factors for VAP, such as prolonged ventilation, pre-existing pulmonary disease, transfusion, re-intubation and enteral feeding, have been extensively described among patients receiving mechanical ventilation in mainland China [8, 9]. However, the reported risk factors were varied or discordant, and there has been no meta-analysis study on this topic until now.…”

Section: Introductionmentioning

confidence: 99%

Incidence, temporal trend and factors associated with ventilator-associated pneumonia in mainland China: a systematic review and meta-analysis

et al. 2017

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BackgroundData to date is far from sufficient to describe the recent epidemiology of ventilator-associated pneumonia (VAP) in mainland China. This study aimed to estimate the overall incidence of VAP, with a special focus on its temporal trend and associated factors.MethodsMeta-analyses of 195 studies published from 2010 to 2015 were conducted, followed by subgroup analyses by methodological quality, pre-defined setting characteristics and attributes of populations.ResultsThe overall cumulative VAP incidence in mainland China was 23.8% (95% confidence interval (CI) 20.6–27.2%), with the results showing high heterogeneity. The pooled incidence densities were 24.14 (95% CI 21.19–27.51) episodes and 22.83 (95% CI 19.88–26.23) patients per 1000 ventilator-days. A decline in the cumulative incidence was observed from 2006 (49.5%, 95% CI 40.0–59.0%) to 2014 (19.6%, 95% CI 10.4–31.0%); differences in the incidence rates were also documented according to Chinese provinces and diagnostic criteria (p < 0.001). Older age (≥60 years), coma, re-intubation, tracheotomy and prolonged ventilation were the factors significantly associated with the occurrence of VAP.ConclusionsThe incidence of VAP remains high in mainland China but has decreased since 2006. The reported rates vary considerably across individual studies, probably due to variations in diagnosis and geographical region. More studies using standard definitions and cut-off points are needed to better clarify the epidemiology of VAP across the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2566-7) contains supplementary material, which is available to authorized users.

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One functional variant in the 3′‐untranslated region of TLR4 is associated with the elevated risk of ventilator‐associated pneumonia in the patients with chronic obstructive pulmonary disease

Zhao

Feng

Zhang

et al. 2019

Journal Cellular Physiology

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The aim of this study was to identify the association polymorphism (rs11536889) in the 3′‐untranslated region (3′‐UTR) of Toll‐like receptors 4 (TLR4) and the risk for ventilator‐associated pneumonia (VAP). miRNA database online and luciferase assays were used to validate TLR4 as the target gene of miR‐1236. Enzyme‐linked immunosorbent assay analysis and western blot were used to analyze the level of TLR4 in different genotype groups. In the present study, miR‐1236 was predicted to bind to the rs11536889 G allele rather than the rs11536889 C allele, which was further confirmed by the luciferase activity suppressed by a fragment of 3′‐UTR containing the rs11536889 G allele induced by lipopolysaccharide (LPS) and interleukin‐6 (IL‐6). Bronchial epithelial cells isolated from participants genotyped as GG, GC, and CC, with no remarkable difference in TLR4 messenger RNA (mRNA) levels were observed among these genotype groups. After stimulating by LPS, a TLR4 ligand, the CC‐genotyped cells expressed higher levels of IL‐8, IL‐6, and tumor necrosis factor alpha (TNF‐α) on their surfaces than cells with the other genotypes. Finally, the western blot analysis results showed that the expression level of IL‐8, IL‐6, and TNF‐α protein was much higher in the CC group than the GC and GG groups subsequent to stimulation by LPS, and the IL‐8, IL‐6, and TNF‐α protein levels in the GC were grouped much lower compared with the GG group. These findings indicated the regulatory association of miR‐1236 with TLR4 and the abnormal expression of TLR4 caused by the presence of rs11536889 in the 3′‐UTR of mRNA, which interfere with its interaction with the miR‐1236, contributing to the risk of VAP.

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Ventilator-associated pneumonia in intensive care units in Hubei Province, China: a multicentre prospective cohort survey

Cited by 54 publications

References 25 publications

Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: Findings of the International Nosocomial Infection Control Consortium

Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: Findings of the International Nosocomial Infection Control Consortium

Incidence, temporal trend and factors associated with ventilator-associated pneumonia in mainland China: a systematic review and meta-analysis

One functional variant in the 3′‐untranslated region of TLR4 is associated with the elevated risk of ventilator‐associated pneumonia in the patients with chronic obstructive pulmonary disease

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