Decreased Risk of Ventilator-Associated Pneumonia in Sepsis Due to Intra-Abdominal Infection

PloS One
François PhilippartOUTCOMEREA Study Group

Abstract

Experimental studies suggest that intra-abdominal infection (IAI) induces biological alterations that may affect the risk of lung infection. To investigate the potential effect of IAI at ICU admission on the subsequent occurrence of ventilator-associated pneumonia (VAP). We used data entered into the French prospective multicenter Outcomerea database in 1997-2011. Consecutive patients who had severe sepsis and/or septic shock at ICU admission and required mechanical ventilation for more than 3 days were included. Patients with acute pancreatitis were not included. Of 2623 database patients meeting the inclusion criteria, 290 (11.1%) had IAI and 2333 (88.9%) had other infections. The IAI group had fewer patients with VAP (56 [19.3%] vs. 806 [34.5%], P<0.01) and longer time to VAP (5.0 vs.10.5 days; P<0.01). After adjustment on independent risk factors for VAP and previous antimicrobial use, IAI was associated with a decreased risk of VAP (hazard ratio, 0.62; 95% confidence interval, 0.46-0.83; P<0.0017). The pathogens responsible for VAP were not different between the groups with and without IAI (Pseudomonas aeruginosa, 345 [42.8%] and 24 [42.8%]; Enterobacteriaceae, 264 [32.8%] and 19 [34.0%]; and Staphylococcus aureus, 215 [26...Continue Reading

References

Nov 1, 1991·The Journal of Clinical Investigation·C MunozJ M Cavaillon
Dec 1, 1988·The American Review of Respiratory Disease·S E HarrisW R Summer
Feb 1, 1986·The Journal of Infectious Diseases·J C WhiteG J Jakab
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Jan 1, 1983·Intensive Care Medicine·A C McCartneyI M Ledingham
Dec 22, 1993·JAMA : the Journal of the American Medical Association·J R Le GallF Saulnier
Mar 9, 1999·International Immunology·B NeumannB Holzmann
Jun 16, 2001·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·E Otero-AntónL F Pérez
Apr 6, 2002·American Journal of Respiratory and Critical Care Medicine·Jean Chastre, Jean-Yves Fagon
Jan 1, 1992·Mathematical Population Studies·R D Gill
Nov 26, 2002·The Journal of Infectious Diseases·Sebastiaan WeijerTom van der Poll
Nov 6, 2003·American Journal of Surgery·Glen A FranklinWilliam G Cheadle
Mar 20, 2004·The Journal of Infectious Diseases·Catherine FittingJean-Marc Cavaillon
Nov 30, 2004·Critical Care : the Official Journal of the Critical Care Forum·Jörg Reutershan, Klaus Ley
Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America
Oct 15, 2005·Nature Reviews. Drug Discovery·Jon A BurasMichail Sitkovsky
Oct 26, 2005·Journal of Leukocyte Biology·Lisa C ParkerIan Sabroe
Nov 3, 2005·Journal of Endotoxin Research·J-M CavaillonM Adib-Conquy
Mar 18, 2006·American Journal of Respiratory Cell and Molecular Biology·Ulrich A MausJürgen Lohmeyer
Mar 23, 2006·Annals of Surgery·David A ThompsonPeter J Pronovost
May 25, 2006·Journal of Endotoxin Research·Jean-Marc Cavaillon, Djillali Annane
Oct 19, 2006·Critical Care : the Official Journal of the Critical Care Forum·Jean-Marc Cavaillon, Minou Adib-Conquy
Mar 17, 2007·Journal of Clinical Immunology·Kamlesh Bhatt, Padmini Salgame
Jun 26, 2007·Shock·J W Olivier van TillMarja A Boermeester
Dec 8, 2007·The Lancet Infectious Diseases·Tom van der Poll, Steven M Opal
Feb 4, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kelby G Maher, Scot T Bateman
May 6, 2009·The Journal of Immunology : Official Journal of the American Association of Immunologists·Carlos del FresnoEduardo López-Collazo
May 19, 2009·American Journal of Respiratory Cell and Molecular Biology·Jacobien J HoogerwerfTom van der Poll
Dec 3, 2009·JAMA : the Journal of the American Medical Association·Jean-Louis VincentUNKNOWN EPIC II Group of Investigators
Jan 27, 2010·Infection and Immunity·Jared T MuenzerRichard S Hotchkiss
Jun 15, 2011·Critical Care Medicine·Andrew Conway MorrisTimothy S Walsh
Aug 16, 2011·Microbes and Infection·Elise G LavoieBarbara I Kazmierczak
Aug 20, 2011·American Journal of Respiratory and Critical Care Medicine·Maarten BekaertUNKNOWN Outcomerea Study Group
Dec 22, 2011·JAMA : the Journal of the American Medical Association·Jonathan S BoomerRichard S Hotchkiss
Feb 11, 2012·American Journal of Respiratory Cell and Molecular Biology·Madhav BhatiaSamithamby Jeyaseelan
Mar 24, 2012·Innate Immunity·Baomei ShaoAlan W Varley
Jun 5, 2012·Biochemical and Biophysical Research Communications·Alessandra Soares-SchanoskiEduardo López-Collazo
Jul 10, 2012·Nature Medicine·Kathleen Raven
Feb 13, 2013·Proceedings of the National Academy of Sciences of the United States of America·Junhee SeokUNKNOWN Inflammation and Host Response to Injury, Large Scale Collaborative Research Program

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Citations

Feb 20, 2020·Critical Care : the Official Journal of the Critical Care Forum·Zhongheng ZhangYunsong Yu

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Methods Mentioned

BETA
bronchoalveolar lavage
bronchoalveolar
lavage

Software Mentioned

SAS
Outcomerea

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