Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study

Anahita Rouzé; Ignacio Martin-Loeches; Pedro Povoa; Demosthenes Makris; Antonio Artigas; Mathilde Bouchereau; Fabien Lambiotte; Matthieu Metzelard; Pierre Cuchet; Claire Boulle Geronimi; Marie Labruyere; Fabienne Tamion; Martine Nyunga; Charles Edouard Luyt; Julien Labreuche; Olivier Pouly; Justine Bardin; Anastasia Saade; Pierre Asfar; Jean Luc Baudel; Alexandra Beurton; Denis Garot; Iliana Ioannidou; Louis Kreitmann; Jean François Llitjos; Eleni Magira; Bruno Mégarbane; David Meguerditchian; Edgar Moglia; Armand Mekontso-Dessap; Jean Reignier; Matthieu Turpin; Alexandre Pierre; Gaetan Plantefeve; Christophe Vinsonneau; Pierre Edouard Floch; Nicolas Weiss; Adrian Ceccato; Antoni Torres; Alain Duhamel; Saad Nseir; coVAPid Study Group

doi:10.1007/s00134-020-06323-9

Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study

Anahita Rouzé, Ignacio Martin-Loeches, Pedro Povoa, Demosthenes Makris, Antonio Artigas, Mathilde Bouchereau, Fabien Lambiotte, Matthieu Metzelard, Pierre Cuchet, Claire Boulle Geronimi, Marie Labruyere, Fabienne Tamion, Martine Nyunga, Charles Edouard Luyt, Julien Labreuche, Olivier Pouly, Justine Bardin, Anastasia Saade, Pierre Asfar, Jean Luc BaudelAlexandra Beurton, Denis Garot, Iliana Ioannidou, Louis Kreitmann, Jean François Llitjos, Eleni Magira, Bruno Mégarbane, David Meguerditchian, Edgar Moglia, Armand Mekontso-Dessap, Jean Reignier, Matthieu Turpin, Alexandre Pierre, Gaetan Plantefeve, Christophe Vinsonneau, Pierre Edouard Floch, Nicolas Weiss, Adrian Ceccato, Antoni Torres, Alain Duhamel, Saad Nseir^*, coVAPid Study Group

^*Kontaktforfatter

KI, OUH, Forskningsenhed for Klinisk Epidemiologi (Odense)

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Abstract

Purpose: Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI. Methods: Multicenter retrospective European cohort performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 h were eligible if they had: SARS-CoV-2 pneumonia, influenza pneumonia, or no viral infection at ICU admission. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. All VA-LRTI were prospectively identified, and chest-X rays were analyzed by at least two physicians. Cumulative incidence of first episodes of VA-LRTI was estimated using the Kalbfleisch and Prentice method, and compared using Fine-and Gray models. Results: 1576 patients were included (568 in SARS-CoV-2, 482 in influenza, and 526 in no viral infection groups). VA-LRTI incidence was significantly higher in SARS-CoV-2 patients (287, 50.5%), as compared to influenza patients (146, 30.3%, adjusted sub hazard ratio (sHR) 1.60 (95% confidence interval (CI) 1.26 to 2.04)) or patients with no viral infection (133, 25.3%, adjusted sHR 1.7 (95% CI 1.2 to 2.39)). Gram-negative bacilli were responsible for a large proportion (82% to 89.7%) of VA-LRTI, mainly Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp. Conclusions: The incidence of VA-LRTI is significantly higher in patients with SARS-CoV-2 infection, as compared to patients with influenza pneumonia, or no viral infection after statistical adjustment, but residual confounding may still play a role in the effect estimates.

Originalsprog	Engelsk
Tidsskrift	Intensive Care Medicine
Vol/bind	47
Udgave nummer	2
Sider (fra-til)	188-198
ISSN	0342-4642
DOI	https://doi.org/10.1007/s00134-020-06323-9
Status	Udgivet - feb. 2021

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10.1007/s00134-020-06323-9

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778569/pdf/134_2020_Article_6323.pdf

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Correction to: Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study (Intensive Care Medicine, (2021), 47, 2, (188-198), 10.1007/s00134-020-06323-9)
Rouzé, A., Martin-Loeches, I., Povoa, P., Makris, D., Artigas, A., Bouchereau, M., Lambiotte, F., Metzelard, M., Cuchet, P., Boulle Geronimi, C., Labruyere, M., Tamion, F., Nyunga, M., Luyt, C. E., Labreuche, J., Pouly, O., Bardin, J., Saade, A., Asfar, P. & Baudel, J. L. & 22 flere, Beurton, A., Garot, D., Ioannidou, I., Kreitmann, L., Llitjos, J. F., Magira, E., Mégarbane, B., Meguerditchian, D., Moglia, E., Mekontso-Dessap, A., Reignier, J., Turpin, M., Pierre, A., Plantefeve, G., Vinsonneau, C., Floch, P. E., Weiss, N., Ceccato, A., Torres, A., Duhamel, A., Nseir, S. & coVAPid Study Group, apr. 2022, I: Intensive Care Medicine. 48, 4, s. 514-515
Publikation: Bidrag til tidsskrift › Kommentar/debat › Forskning › peer review

Citationsformater

Rouzé, A., Martin-Loeches, I., Povoa, P., Makris, D., Artigas, A., Bouchereau, M., Lambiotte, F., Metzelard, M., Cuchet, P., Boulle Geronimi, C., Labruyere, M., Tamion, F., Nyunga, M., Luyt, C. E., Labreuche, J., Pouly, O., Bardin, J., Saade, A., Asfar, P., ... coVAPid Study Group (2021). Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. Intensive Care Medicine, 47(2), 188-198. https://doi.org/10.1007/s00134-020-06323-9

@article{9ebae1f77e3b460eba33dd2cc883f295,

title = "Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study",

abstract = "Purpose: Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI. Methods: Multicenter retrospective European cohort performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 h were eligible if they had: SARS-CoV-2 pneumonia, influenza pneumonia, or no viral infection at ICU admission. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. All VA-LRTI were prospectively identified, and chest-X rays were analyzed by at least two physicians. Cumulative incidence of first episodes of VA-LRTI was estimated using the Kalbfleisch and Prentice method, and compared using Fine-and Gray models. Results: 1576 patients were included (568 in SARS-CoV-2, 482 in influenza, and 526 in no viral infection groups). VA-LRTI incidence was significantly higher in SARS-CoV-2 patients (287, 50.5%), as compared to influenza patients (146, 30.3%, adjusted sub hazard ratio (sHR) 1.60 (95% confidence interval (CI) 1.26 to 2.04)) or patients with no viral infection (133, 25.3%, adjusted sHR 1.7 (95% CI 1.2 to 2.39)). Gram-negative bacilli were responsible for a large proportion (82% to 89.7%) of VA-LRTI, mainly Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp. Conclusions: The incidence of VA-LRTI is significantly higher in patients with SARS-CoV-2 infection, as compared to patients with influenza pneumonia, or no viral infection after statistical adjustment, but residual confounding may still play a role in the effect estimates.",

keywords = "COVID-19, Critical illness, SARS-CoV-2, Ventilator-associated pneumonia, Ventilator-associated tracheobronchitis, Europe, Humans, Influenza, Human/epidemiology, Middle Aged, Pneumonia, Ventilator-Associated/epidemiology, Male, Respiratory Tract Infections/epidemiology, Incidence, Ventilators, Mechanical, COVID-19/epidemiology, Female, Aged, Retrospective Studies",

author = "Anahita Rouz{\'e} and Ignacio Martin-Loeches and Pedro Povoa and Demosthenes Makris and Antonio Artigas and Mathilde Bouchereau and Fabien Lambiotte and Matthieu Metzelard and Pierre Cuchet and {Boulle Geronimi}, Claire and Marie Labruyere and Fabienne Tamion and Martine Nyunga and Luyt, {Charles Edouard} and Julien Labreuche and Olivier Pouly and Justine Bardin and Anastasia Saade and Pierre Asfar and Baudel, {Jean Luc} and Alexandra Beurton and Denis Garot and Iliana Ioannidou and Louis Kreitmann and Llitjos, {Jean Fran{\c c}ois} and Eleni Magira and Bruno M{\'e}garbane and David Meguerditchian and Edgar Moglia and Armand Mekontso-Dessap and Jean Reignier and Matthieu Turpin and Alexandre Pierre and Gaetan Plantefeve and Christophe Vinsonneau and Floch, {Pierre Edouard} and Nicolas Weiss and Adrian Ceccato and Antoni Torres and Alain Duhamel and Saad Nseir and {coVAPid Study Group}",

year = "2021",

month = feb,

doi = "10.1007/s00134-020-06323-9",

language = "English",

volume = "47",

pages = "188--198",

journal = "Intensive Care Medicine",

issn = "0342-4642",

publisher = "Springer Science+Business Media",

number = "2",

}

Rouzé, A, Martin-Loeches, I, Povoa, P, Makris, D, Artigas, A, Bouchereau, M, Lambiotte, F, Metzelard, M, Cuchet, P, Boulle Geronimi, C, Labruyere, M, Tamion, F, Nyunga, M, Luyt, CE, Labreuche, J, Pouly, O, Bardin, J, Saade, A, Asfar, P, Baudel, JL, Beurton, A, Garot, D, Ioannidou, I, Kreitmann, L, Llitjos, JF, Magira, E, Mégarbane, B, Meguerditchian, D, Moglia, E, Mekontso-Dessap, A, Reignier, J, Turpin, M, Pierre, A, Plantefeve, G, Vinsonneau, C, Floch, PE, Weiss, N, Ceccato, A, Torres, A, Duhamel, A, Nseir, S & coVAPid Study Group 2021, 'Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study', Intensive Care Medicine, bind 47, nr. 2, s. 188-198. https://doi.org/10.1007/s00134-020-06323-9

Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study. / Rouzé, Anahita; Martin-Loeches, Ignacio; Povoa, Pedro et al.
I: Intensive Care Medicine, Bind 47, Nr. 2, 02.2021, s. 188-198.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections

T2 - a European multicenter cohort study

AU - Rouzé, Anahita

AU - Martin-Loeches, Ignacio

AU - Povoa, Pedro

AU - Makris, Demosthenes

AU - Artigas, Antonio

AU - Bouchereau, Mathilde

AU - Lambiotte, Fabien

AU - Metzelard, Matthieu

AU - Cuchet, Pierre

AU - Boulle Geronimi, Claire

AU - Labruyere, Marie

AU - Tamion, Fabienne

AU - Nyunga, Martine

AU - Luyt, Charles Edouard

AU - Labreuche, Julien

AU - Pouly, Olivier

AU - Bardin, Justine

AU - Saade, Anastasia

AU - Asfar, Pierre

AU - Baudel, Jean Luc

AU - Beurton, Alexandra

AU - Garot, Denis

AU - Ioannidou, Iliana

AU - Kreitmann, Louis

AU - Llitjos, Jean François

AU - Magira, Eleni

AU - Mégarbane, Bruno

AU - Meguerditchian, David

AU - Moglia, Edgar

AU - Mekontso-Dessap, Armand

AU - Reignier, Jean

AU - Turpin, Matthieu

AU - Pierre, Alexandre

AU - Plantefeve, Gaetan

AU - Vinsonneau, Christophe

AU - Floch, Pierre Edouard

AU - Weiss, Nicolas

AU - Ceccato, Adrian

AU - Torres, Antoni

AU - Duhamel, Alain

AU - Nseir, Saad

AU - coVAPid Study Group

PY - 2021/2

Y1 - 2021/2

N2 - Purpose: Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI. Methods: Multicenter retrospective European cohort performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 h were eligible if they had: SARS-CoV-2 pneumonia, influenza pneumonia, or no viral infection at ICU admission. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. All VA-LRTI were prospectively identified, and chest-X rays were analyzed by at least two physicians. Cumulative incidence of first episodes of VA-LRTI was estimated using the Kalbfleisch and Prentice method, and compared using Fine-and Gray models. Results: 1576 patients were included (568 in SARS-CoV-2, 482 in influenza, and 526 in no viral infection groups). VA-LRTI incidence was significantly higher in SARS-CoV-2 patients (287, 50.5%), as compared to influenza patients (146, 30.3%, adjusted sub hazard ratio (sHR) 1.60 (95% confidence interval (CI) 1.26 to 2.04)) or patients with no viral infection (133, 25.3%, adjusted sHR 1.7 (95% CI 1.2 to 2.39)). Gram-negative bacilli were responsible for a large proportion (82% to 89.7%) of VA-LRTI, mainly Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp. Conclusions: The incidence of VA-LRTI is significantly higher in patients with SARS-CoV-2 infection, as compared to patients with influenza pneumonia, or no viral infection after statistical adjustment, but residual confounding may still play a role in the effect estimates.

AB - Purpose: Although patients with SARS-CoV-2 infection have several risk factors for ventilator-associated lower respiratory tract infections (VA-LRTI), the reported incidence of hospital-acquired infections is low. We aimed to determine the relationship between SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, and the incidence of VA-LRTI. Methods: Multicenter retrospective European cohort performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 h were eligible if they had: SARS-CoV-2 pneumonia, influenza pneumonia, or no viral infection at ICU admission. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. All VA-LRTI were prospectively identified, and chest-X rays were analyzed by at least two physicians. Cumulative incidence of first episodes of VA-LRTI was estimated using the Kalbfleisch and Prentice method, and compared using Fine-and Gray models. Results: 1576 patients were included (568 in SARS-CoV-2, 482 in influenza, and 526 in no viral infection groups). VA-LRTI incidence was significantly higher in SARS-CoV-2 patients (287, 50.5%), as compared to influenza patients (146, 30.3%, adjusted sub hazard ratio (sHR) 1.60 (95% confidence interval (CI) 1.26 to 2.04)) or patients with no viral infection (133, 25.3%, adjusted sHR 1.7 (95% CI 1.2 to 2.39)). Gram-negative bacilli were responsible for a large proportion (82% to 89.7%) of VA-LRTI, mainly Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp. Conclusions: The incidence of VA-LRTI is significantly higher in patients with SARS-CoV-2 infection, as compared to patients with influenza pneumonia, or no viral infection after statistical adjustment, but residual confounding may still play a role in the effect estimates.

KW - COVID-19

KW - Critical illness

KW - SARS-CoV-2

KW - Ventilator-associated pneumonia

KW - Ventilator-associated tracheobronchitis

KW - Europe

KW - Humans

KW - Influenza, Human/epidemiology

KW - Middle Aged

KW - Pneumonia, Ventilator-Associated/epidemiology

KW - Male

KW - Respiratory Tract Infections/epidemiology

KW - Incidence

KW - Ventilators, Mechanical

KW - COVID-19/epidemiology

KW - Female

KW - Aged

KW - Retrospective Studies

UR - https://link.springer.com/article/10.1007%2Fs00134-021-06588-8

U2 - 10.1007/s00134-020-06323-9

DO - 10.1007/s00134-020-06323-9

M3 - Journal article

C2 - 33388794

AN - SCOPUS:85098496448

SN - 0342-4642

VL - 47

SP - 188

EP - 198

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 2

ER -

Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study

Abstract

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Correction to: Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: a European multicenter cohort study (Intensive Care Medicine, (2021), 47, 2, (188-198), 10.1007/s00134-020-06323-9)

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