Titre :

Early Bacterial Identification Among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Cohort Study.

Auteur(s) :

Rouze, Anahita [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Martin-Loeches, I. [Auteur]
Povoa, P. [Auteur]
Metzelard, M. [Auteur]
Du Cheyron, D. [Auteur]
Lambiotte, F. [Auteur]
Tamion, F. [Auteur]
Labruyere, M. [Auteur]
Boulle Geronimi, C. [Auteur]
Nieszkowska, A. [Auteur]
Nyunga, M. [Auteur]
Pouly, O. [Auteur]
Thille, A. W. [Auteur]
Megarbane, B. [Auteur]
Saade, A. [Auteur]
Diaz, E. [Auteur]
Magira, E. [Auteur]
Llitjos, J. F. [Auteur]
Cilloniz, C. [Auteur]
Ioannidou, I. [Auteur]
Pierre, A. [Auteur]
Reignier, J. [Auteur]
Garot, D. [Auteur]
Kreitmann, L. [Auteur]
Baudel, J. L. [Auteur]
Fartoukh, M. [Auteur]
Plantefeve, G. [Auteur]
Beurton, A. [Auteur]
Asfar, P. [Auteur]
Boyer, A. [Auteur]
Mekontso-Dessap, A. [Auteur]
Makris, D. [Auteur]
Vinsonneau, C. [Auteur]
Floch, P. E. [Auteur]
Weiss, N. [Auteur]
Ceccato, A. [Auteur]
Artigas, A. [Auteur]
Bouchereau, M. [Auteur]
Duhamel, Alain [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Nseir, Saad [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Titre de la revue :

Am J Respir Crit Care Med

Nom court de la revue :

Am J Respir Crit Care Med

Numéro :

204

Pagination :

546-556

Date de publication :

2021-09-01

ISSN :

1535-4970

Mot(s)-clé(s) :

SARS-CoV-2
influenza
bacterial
intensive care
mechanical ventilation

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Rationale: Early empirical antimicrobial treatment is frequently prescribed to critically ill patients with coronavirus disease (COVID-19) based on Surviving Sepsis Campaign guidelines. Objectives: We aimed to determine ...
Lire la suite >Rationale: Early empirical antimicrobial treatment is frequently prescribed to critically ill patients with coronavirus disease (COVID-19) based on Surviving Sepsis Campaign guidelines. Objectives: We aimed to determine the prevalence of early bacterial identification in intubated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, as compared with influenza pneumonia, and to characterize its microbiology and impact on outcomes. Methods: A multicenter retrospective European cohort was performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation >48 hours were eligible if they had SARS-CoV-2 or influenza pneumonia at ICU admission. Bacterial identification was defined by a positive bacterial culture within 48 hours after intubation in endotracheal aspirates, BAL, blood cultures, or a positive pneumococcal or legionella urinary antigen test. Measurements and Main Results: A total of 1,050 patients were included (568 in SARS-CoV-2 and 482 in influenza groups). The prevalence of bacterial identification was significantly lower in patients with SARS-CoV-2 pneumonia compared with patients with influenza pneumonia (9.7 vs. 33.6%; unadjusted odds ratio, 0.21; 95% confidence interval [CI], 0.15–0.30; adjusted odds ratio, 0.23; 95% CI, 0.16–0.33; P < 0.0001). Gram-positive cocci were responsible for 58% and 72% of coinfection in patients with SARS-CoV-2 and influenza pneumonia, respectively. Bacterial identification was associated with increased adjusted hazard ratio for 28-day mortality in patients with SARS-CoV-2 pneumonia (1.57; 95% CI, 1.01–2.44; P = 0.043). However, no significant difference was found in the heterogeneity of outcomes related to bacterial identification between the two study groups, suggesting that the impact of coinfection on mortality was not different between patients with SARS-CoV-2 and influenza. Conclusions: Bacterial identification within 48 hours after intubation is significantly less frequent in patients with SARS-CoV-2 pneumonia than patients with influenza pneumonia.Clinical trial registered with www.clinicaltrials.gov (NCT 04359693).Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T06:34:28Z
2023-11-30T08:44:23Z