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http://hdl.handle.net/2445/184992
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DC Field | Value | Language |
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dc.contributor.author | Ceccato, Adrian | - |
dc.contributor.author | Dominedò, Cristina | - |
dc.contributor.author | Ferrer Monreal, Miquel | - |
dc.contributor.author | Martín Loeches, Ignacio | - |
dc.contributor.author | Barbeta, Enric | - |
dc.contributor.author | Gabarrús, Albert | - |
dc.contributor.author | Cillóniz, Catia | - |
dc.contributor.author | Ranzani, Otavio T. | - |
dc.contributor.author | Pascale, Gennaro de | - |
dc.contributor.author | Nogas, Stefano | - |
dc.contributor.author | Di Giannatale, Pierluigi | - |
dc.contributor.author | Antonelli, Massimo | - |
dc.contributor.author | Torres Martí, Antoni | - |
dc.date.accessioned | 2022-04-19T07:20:17Z | - |
dc.date.available | 2022-09-02T05:10:28Z | - |
dc.date.issued | 2021-09-02 | - |
dc.identifier.issn | 1399-3003 | - |
dc.identifier.uri | http://hdl.handle.net/2445/184992 | - |
dc.description.abstract | Ventilator-associated pneumonia is a leading infectious cause of morbidity in critically ill patients; yet current guidelines offer no indications for follow-up cultures.We aimed to evaluate the role of follow-up cultures and microbiological response 3 days after diagnosing ventilator-associated pneumonia as predictors of short- and long-term outcomes.We performed a retrospective analysis of a cohort prospectively collected from 2004 to 2017. Ventilator-associated pneumonia was diagnosed based on clinical, radiographic, and microbiological criteria. For microbiological identification, a tracheobronchial aspirate was performed at diagnosis and repeated after 72?h. We defined three groups when comparing the two tracheobronchial aspirate results: persistence, superinfection, and eradication of causative pathogens.One-hundred-fifty-seven patients were enrolled in the study, among whom microbiological persistence, superinfection, and eradication was present in 67 (48%), 25 (16%), and 65 (41%), respectively, after 72hs. Those with superinfection had the highest mortalities in the intensive care unit (p=0.015) and at 90?days (p=0.036), while also having the fewest ventilation-free days (p=0.024). Multivariable analysis revealed shock at VAP diagnosis (odds ratios [OR] 3.43; 95% confidence interval [CI] 1.25 to 9.40), Staphylococcus aureus isolation at VAP diagnosis (OR 2.87; 95%CI 1.06 to 7.75), and hypothermia at VAP diagnosis (OR 0.67; 95%CI 0.48 to 0.95, per +1°C) to be associated with superinfection.Our retrospective analysis suggests that ventilator-associated pneumonia short-term and long-term outcomes may be associated with superinfection in follow-up cultures. Follow-up cultures may help guiding antibiotic therapy and its duration. Further prospective studies are necessary to verify our findings. | - |
dc.format.extent | 48 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | European Respiratory Society | - |
dc.relation.isformatof | Versió postprint del document publicat a: https://doi.org/10.1183/13993003.00620-2021 | - |
dc.relation.ispartof | European Respiratory Journal, 2021-NA | - |
dc.relation.uri | https://doi.org/10.1183/13993003.00620-2021 | - |
dc.rights | (c) Cilloniz et al., 2021 | - |
dc.source | Articles publicats en revistes (Medicina) | - |
dc.subject.classification | Staphylococcus aureus | - |
dc.subject.classification | Pneumònia | - |
dc.subject.classification | Respiració artificial | - |
dc.subject.other | Staphylococcus aureus | - |
dc.subject.other | Pneumonia | - |
dc.subject.other | Artificial respiration | - |
dc.title | Prediction of ventilator-associated pneumonia outcomes according to the early microbiological response: a retrospective observational study | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/acceptedVersion | - |
dc.identifier.idgrec | 721183 | - |
dc.date.updated | 2022-03-15T08:05:00Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.idimarina | 9275469 | - |
dc.identifier.pmid | 34475230 | - |
Appears in Collections: | Articles publicats en revistes (ISGlobal) Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
Files in This Item:
File | Description | Size | Format | |
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12474_9275469_prediction_of_vap_outcomes_according_to_the_early_microbiological.pdf | 1.17 MB | Adobe PDF | View/Open |
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