Article
Immunology
Owen R. Albin, Keith S. Kaye, Erin K. McCreary, Jason M. Pogue
Summary: Further study is needed to determine the optimal duration of antimicrobial treatment for ventilator-associated pneumonia caused by Pseudomonas aeruginosa. The recommended duration of antimicrobial treatment for this condition has evolved over the past few decades. This viewpoint provides a review of landmark trials and the evolution of expert consensus guidelines, highlighting the need for future research.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Infectious Diseases
Amira Mohamed, Enas Daef, Amany Nafie, Lamia Shaban, Maggie Ibrahim
Summary: This study aimed to investigate the frequency of carbapenem-resistance and the rates of MDR, XDR, and PDR in CR-GNB infections in VAP. The study found a high presence of carbapenem-resistance genes in the isolates, with bla(NDM) being the most predominant gene. All isolates exhibited high resistance to most antibiotics.
Article
Critical Care Medicine
Antonio Rosano, Enrico Martinelli, Federica Fusina, Filippo Albani, Rosalba Caserta, Alessandro Morandi, Piera Dell'Agnolo, Alessandra Dicembrini, Leila Mansouri, Andrea Marchini, Valeria Schivalocchi, Giuseppe Natalini
Summary: The study found that early percutaneous tracheostomy is safe and effective in COVID-19 patients, improving survival rates and increasing the likelihood of weaning from tracheostomy at ICU discharge. This highlights the importance of early tracheotomy in managing COVID-19 patients.
CRITICAL CARE MEDICINE
(2021)
Review
Infectious Diseases
Louis Kreitmann, Alexandre Gaudet, Saad Nseir
Summary: Immunocompromised patients, who include individuals with cancer, hematological malignancies, solid organ transplants, and those receiving immunosuppressive therapies, have a higher risk of healthcare-associated and ICU-acquired infections, particularly ventilator-associated lower respiratory tract infections (VA-LTRI). Recent studies have challenged previous beliefs about the incidence of VA-LTRI and its association with multidrug-resistant bacteria in immunocompromised patients. This narrative review explores the specific features of VA-LTRI in this population, the importance of etiological diagnosis, and the impact of immunosuppression on outcomes.
Article
Infectious Diseases
G. Dimopoulos, M. P. Almyroudi, I Kapralos, O. Apostolopoulou, A. Flevari, D. P. Nicolau, A. Dokoumetzidis
Summary: This study aimed to evaluate the pharmacokinetics of off-label high-dose tigecycline in patients with ventilator-associated pneumonia (VAP). The results showed that a daily dose of 200 mg tigecycline can increase drug concentrations in plasma and epithelial lining fluid (ELF), and the high ELF penetration supports the effectiveness of tigecycline in VAP.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2022)
Article
Respiratory System
Yingjian Liang, Chengrui Zhu, Cong Tian, Qizhong Lin, Zhiliang Li, Zhifei Li, Dongshu Ni, Xiaochun Ma
Summary: This study developed machine learning models for early detection of ventilator-associated pneumonia (VAP), achieving high performance compared to Clinical Pulmonary Infection Score (CPIS) model in terms of AUC, sensitivity, and specificity.
BMC PULMONARY MEDICINE
(2022)
Article
Critical Care Medicine
Dominic Fenn, Mahmoud Abdel-Aziz, Pouline M. P. van Oort, Paul Brinkman, Waqar M. Ahmed, Timothy Felton, Antonio Artigas, Pedro Povoa, Ignacio Martin-Loeches, Marcus J. Schultz, Paul Dark, Stephen J. Fowler, Lieuwe D. J. Bos
Summary: Using 16s rRNA sequencing, we analyzed the airway microbiota of patients with ventilator-associated pneumonia (VAP). We found that patients with positive cultures had dysbiosis and increased relative abundance of pathogenic bacteria. Increased IL-1 beta expression was associated with reduced microbial diversity and presence of pathogenic bacteria. Diagnostic accuracy improved when using pathogen-specific relative abundance thresholds.
Article
Critical Care Medicine
Saad Nseir, Ignacio Martin-Loeches, Pedro Povoa, Matthieu Metzelard, Damien Du Cheyron, Fabien Lambiotte, Fabienne Tamion, Marie Labruyere, Demosthenes Makris, Claire Boulle Geronimi, Marc Pinetonde Chambrun, Martine Nyunga, Olivier Pouly, Bruno Megarbane, Anastasia Saade, Gemma Goma, Eleni Magira, Jean-Francois Llitjos, Antoni Torres, Iliana Ioannidou, Alexandre Pierre, Luis Coelho, Jean Reignier, Denis Garot, Louis Kreitmann, Jean-Luc Baudel, Guillaume Voiriot, Damien Contou, Alexandra Beurton, Pierre Asfar, Alexandre Boyer, Arnaud W. Thille, Armand Mekontso-Dessap, Vassiliki Tsolaki, Christophe Vinsonneau, Pierre-Edouard Floch, Loic Le Guennec, Adrian Ceccato, Antonio Artigas, Mathilde Bouchereau, Julien Labreuche, Alain Duhamel, Anahita Rouze
Summary: This study found that VAP was significantly associated with increased 28-day mortality in SARS-CoV-2 patients, but SARS-CoV-2 pneumonia did not significantly modify the relationship between VAP and 28-day mortality compared to influenza pneumonia or no viral infection.
Article
Multidisciplinary Sciences
Ari Meliyanti, Desy Rusmawatiningtyas, Firdian Makrufardi, Eggi Arguni
Summary: This study aimed to identify factors associated with mortality in pediatric pneumonia, and found that bacteremia and underweight were predictors of mortality for pediatric patients with pneumonia who were supported by mechanical ventilation. Comparing these findings with other centers is necessary.
Article
Infectious Diseases
Maria Sdougka, Maria Simitsopoulou, Elena Volakli, Asimina Violaki, Vivian Georgopoulou, Argiro Ftergioti, Emmanuel Roilides, Elias Iosifidis
Summary: This study aimed to evaluate whether rapid molecular diagnostics in combination with Clinically Pulmonary Index Score (CPIS) scoring, microbiological surveillance, and biomarker measurements of PTX-3, SP-D, s-TREM, IL-1 beta, and IL-8 could improve the accuracy of VAP diagnosis and follow-up in critically ill children. The results showed that these biomarkers could not discriminate between patients with a high or low suspicion of VAP diagnosis.
Article
Anesthesiology
T. W. Felton, W. Ahmed, I. R. White, P. van Oort, N. J. W. Rattray, C. Docherty, J. Bannard-Smith, B. Morton, I. Welters, R. McMullan, S. A. Roberts, R. Goodacre, P. M. Dark, S. J. Fowler
Summary: Ventilator-associated pneumonia is common in critically ill patients, leading to overuse of antibiotics and antimicrobial resistance. This study explores the non-invasive diagnosis of ventilator-associated pneumonia through the detection of volatile organic compounds in exhaled breath.
Article
Microbiology
Fabio Aguiar-Alves, Hoan N. Le, Vuvi G. Tran, Emmanuelle Gras, Trang T. T. Vu, Oliver X. Dong, Josiane Silva Quetz, Lily Cheng, Li Yu, Bret R. Sellman, Charles K. Stover, Antonio DiGiandomenico, Binh An Diep
Summary: The use of MEDI3902 antibody for prophylactic treatment has been shown to protect rabbits from Pseudomonas aeruginosa infection and reduce lung lesions and bacteremia. Compared to MEDI3902 treatment, rabbits treated with irrelevant control IgG exhibited severe pneumonia and systemic pathophysiological changes. These results suggest that MEDI3902 prophylaxis can decrease the severity of P. aeruginosa ventilator-associated pneumonia.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Pharmacology & Pharmacy
Luming Zhang, Shaojin Li, Xuehao Lu, Yu Liu, Yinlong Ren, Tao Huang, Jun Lyu, Haiyan Yin
Summary: The study demonstrated that thiamine supplementation may reduce ICU and in-hospital mortality in patients with VAP, suggesting that further clinical trials should be conducted to provide more-solid evidence on its efficacy in improving patient outcomes.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Public, Environmental & Occupational Health
Xiaomeng Yi, Xuxia Wei, Mi Zhou, Yingying Ma, Jinfeng Zhuo, Xin Sui, Yuling An, Haijin Lv, Yang Yang, Huimin Yi
Summary: In two intensive care unit settings in China, the implementation of a comprehensive unit-based safety program (CUSP) effectively reduced the incidence of ventilator-associated pneumonia (VAP) and other infections in patients receiving mechanical ventilation. It also prolonged the time until VAP occurrence, reduced the days of antibiotic use for VAP, shortened the length of stay in the ICU and hospital, and enhanced safety culture awareness.
FRONTIERS IN PUBLIC HEALTH
(2022)
Review
Critical Care Medicine
Giacomo Grasselli, Emanuele Cattaneo, Gaetano Florio
Summary: This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021, with more information available at the provided links.