Impact of immunosuppression on incidence, ...
Document type :
Compte-rendu et recension critique d'ouvrage
Title :
Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections
Author(s) :
Moreau, Anne-Sophie [Auteur]
Martin-Loeches, Ignacio [Auteur]
St James's University Hospital
Povoa, Pedro [Auteur]
Salluh, Jorge [Auteur]
Rodriguez, Alejandro [Auteur]
Thille, Arnaud W. [Auteur]
Diaz Santos, Emilio [Auteur]
Vedes, Elisa [Auteur]
Lobo, Suzana Margareth [Auteur]
Mégarbane, Bruno [Auteur]
Variabilité de réponse aux Psychotropes [VariaPsy - U1144]
Optimisation thérapeutique en Neuropsychopharmacologie [OPTeN (UMR_S 1144 / U1144)]
Molero Silvero, Esperanza [Auteur]
Coelho, Luis [Auteur]
Argaud, Laurent [Auteur]
Hospices Civils de Lyon [HCL]
Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Sanchez Iniesta, Rafael [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rouzé, Anahita [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Inflammation Research International Center - U 995 [LIRIC]
Préau, Sébastien [Auteur]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Martin-Loeches, Ignacio [Auteur]
St James's University Hospital
Povoa, Pedro [Auteur]
Salluh, Jorge [Auteur]
Rodriguez, Alejandro [Auteur]
Thille, Arnaud W. [Auteur]
Diaz Santos, Emilio [Auteur]
Vedes, Elisa [Auteur]
Lobo, Suzana Margareth [Auteur]
Mégarbane, Bruno [Auteur]
Variabilité de réponse aux Psychotropes [VariaPsy - U1144]
Optimisation thérapeutique en Neuropsychopharmacologie [OPTeN (UMR_S 1144 / U1144)]
Molero Silvero, Esperanza [Auteur]
Coelho, Luis [Auteur]
Argaud, Laurent [Auteur]
Hospices Civils de Lyon [HCL]
Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Sanchez Iniesta, Rafael [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rouzé, Anahita [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Nseir, Saad [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Inflammation Research International Center - U 995 [LIRIC]
Préau, Sébastien [Auteur]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Journal title :
European Respiratory Journal
Pages :
1701656
Publisher :
European Respiratory Society
Publication date :
2018-03-08
ISSN :
0903-1936
English keyword(s) :
antibiotic-therapy
critically-ill patients
intensive-care-unit
severe sepsis
mortality
Respiratory System
antimicrobial treatment
attributable
comatose patients
de-escalation
early-onset pneumonia
resistant-bacteria
critically-ill patients
intensive-care-unit
severe sepsis
mortality
Respiratory System
antimicrobial treatment
attributable
comatose patients
de-escalation
early-onset pneumonia
resistant-bacteria
HAL domain(s) :
Sciences du Vivant [q-bio]
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies émergentes
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies infectieuses
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Pneumologie et système respiratoire
Sciences du Vivant [q-bio]/Toxicologie
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies émergentes
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Maladies infectieuses
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Pneumologie et système respiratoire
Sciences du Vivant [q-bio]/Toxicologie
English abstract : [en]
The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in ...
Show more >The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients. All patients receiving mechanical ventilation for \textgreater48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297). The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53-0.80; p\textless0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; subhazard ratio 0.61, 95% CI 0.45-0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54-0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrugresistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78-4.02; p\textless0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p\textless0.001). Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.Show less >
Show more >The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients. All patients receiving mechanical ventilation for \textgreater48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297). The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53-0.80; p\textless0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; subhazard ratio 0.61, 95% CI 0.45-0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54-0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrugresistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78-4.02; p\textless0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p\textless0.001). Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.Show less >
Language :
Anglais
Popular science :
Non
Collections :
Source :
Files
- 1701656.full.pdf
- Open access
- Access the document