Journal of Clinical Medicine (Feb 2021)
Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study
- Daniele Roberto Giacobbe,
- Denise Battaglini,
- Elisa Martina Enrile,
- Chiara Dentone,
- Antonio Vena,
- Chiara Robba,
- Lorenzo Ball,
- Michele Bartoletti,
- Irene Coloretti,
- Stefano Di Bella,
- Antonio Di Biagio,
- Iole Brunetti,
- Malgorzata Mikulska,
- Novella Carannante,
- Andrea De Maria,
- Laura Magnasco,
- Alberto Enrico Maraolo,
- Michele Mirabella,
- Giorgia Montrucchio,
- Nicolò Patroniti,
- Lucia Taramasso,
- Giusy Tiseo,
- Giacomo Fornaro,
- Fiorentino Fraganza,
- Luca Monastra,
- Erik Roman-Pognuz,
- Giacomo Paluzzano,
- Giuseppe Fiorentino,
- Antonio Corcione,
- Linda Bussini,
- Renato Pascale,
- Silvia Corcione,
- Tommaso Tonetti,
- Matteo Rinaldi,
- Marco Falcone,
- Emanuela Biagioni,
- Vito Marco Ranieri,
- Maddalena Giannella,
- Francesco Giuseppe De Rosa,
- Massimo Girardis,
- Francesco Menichetti,
- Pierluigi Viale,
- Paolo Pelosi,
- Matteo Bassetti
Affiliations
- Daniele Roberto Giacobbe
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Denise Battaglini
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Elisa Martina Enrile
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Chiara Dentone
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Antonio Vena
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Chiara Robba
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Lorenzo Ball
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Michele Bartoletti
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Irene Coloretti
- Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy
- Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy
- Antonio Di Biagio
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Iole Brunetti
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Malgorzata Mikulska
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Novella Carannante
- Emergenza Infettivologica PS, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
- Andrea De Maria
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Laura Magnasco
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Alberto Enrico Maraolo
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
- Michele Mirabella
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Giorgia Montrucchio
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
- Nicolò Patroniti
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Lucia Taramasso
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy
- Giacomo Fornaro
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Fiorentino Fraganza
- Intensive Care Unit, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
- Luca Monastra
- Intensive Care Unit, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
- Erik Roman-Pognuz
- Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy
- Giacomo Paluzzano
- Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy
- Giuseppe Fiorentino
- SubIntensiva Covid, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
- Antonio Corcione
- Dipartimento Area Critica, AORN dei Colli, 80131 Naples, Italy
- Linda Bussini
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Renato Pascale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
- Tommaso Tonetti
- Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Matteo Rinaldi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy
- Emanuela Biagioni
- Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy
- Vito Marco Ranieri
- Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Maddalena Giannella
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Francesco Giuseppe De Rosa
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
- Massimo Girardis
- Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy
- Francesco Menichetti
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy
- Pierluigi Viale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
- Paolo Pelosi
- Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- Matteo Bassetti
- Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
- DOI
- https://doi.org/10.3390/jcm10040555
- Journal volume & issue
-
Vol. 10,
no. 4
p. 555
Abstract
The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
Keywords