Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Conway Morris, A.; Kohler, K.; De Corte, T.; Ercole, A.; De Grooth, H.-J.; Elbers, P.W.G.; Povoa, P.; Morais, R.; Koulenti, D.; Jog, S.; Nielsen, N.; Jubb, A.; Cecconi, M.; De Waele, J.; Bezzi, M.; Gira, A.; Eller, P.; Hamid, T.; Haque, I.U.; De Buyser, W.; Cudia, A.; De Backer, D.; Foulon, P.; Collin, V.; Van Hecke, J.; De Waele, E.; Van Malderen, C.; Mesland, J.-B.; Piagnerelli, M.; Haentjens, L.; De Schryver, N.; Van Leemput, J.; Vanhove, P.; Bulpa, P.; Ilieva, V.; Katz, D.; Geagea, A.; Binnie, A.; Tirapegui, F.; Lago, G.; Graf, J.; Perez-Araos, R.; Vargas, P.; Martinez, F.; Labarca, E.; Franco, D.M.; Parra-Tanoux, D.; Reyes, L.F.; Yepes, D.; Periš, F.; Stipic, S.S.; Burgos, C.V.C.; Boada, P.R.N.; Brun, J.L.B.; Ballesteros, J.P.P.; Hammouda, A.; Elmandouh, O.; Azzam, A.; Hussein, A.M.; Galal, I.; Awad, A.K.; Azab, M.A.; Abdalla, M.; Assal, H.; Alfishawy, M.; Ghozy, S.; Tharwat, S.; Eldaly, A.; Reinhard, V.; Chrisment, A.; Poyat, C.; Badie, J.; Ferrari, F.B.; Weiss, B.; Kuhn, K.F.; Grunow, J.J.; Lorenz, M.; Schaller, S.; Spieth, P.; Bota, M.; Fichtner, F.; Fuest, K.; Lahmer, T.; Herrmann, J.; Meybohm, P.; Markou, N.; Vasileiadou, G.; Chrysanthopoulou, E.; Papamichalis, P.; Soultati, I.; Kalvit, K.; Myatra, S.N.; Krupa, I.; Tharwat, A.; Nichol, A.; McCarthy, A.; Mahmoodpoor, A.; Tonetti, T.; Isoni, P.; Spadaro, S.; Volta, C.A.; Mirabella, L.; Noto, A.; Florio, G.; Guzzardella, A.; Paleari, C.; Baccanelli, F.; Savi, M.; Antonelli, M.; Vaccarini, B.; Montrucchio, G.; Sales, G.; Donadello, K.; Gottin, L.; Polati, E.; De Rosa, S.; Sulemanji, D.; Abusalama, A.; Elhadi, M.; De Jesus, M.F.; Gonzalez, D.R.; Canedo, N.; Chavez, A.E.; Dendane, T.; Grady, B.; de Jong, B.; van der Heiden, E.; Thoral, P.; van den Bogaard, B.; Spronk, P.E.; Achterberg, S.; Groeneveld, M.; So, R.K.L.; de Wijs, C.; Scholten, H.; Beishuizen, A.; Cornet, A.D.; Reidinga, A.C.; Kranen, H.; Mensink, R.; Boer, S.; de Groot, M.; Beck, O.; Bethlehem, C.; van Bussel, B.; Frenzel, T.; de Jong, C.; Wilting, R.; Kesecioglu, J.; Mehagnoul-Schipper, J.; Alasia, D.; Kumar, A.; Qayyum, A.; Rana, M.; Jayyab, M.A.; Sierra, R.Q.; Hernandez, A.M.; Taborda, L.; Ramires, T.; Silva, C.; Roriz, C.; Patricio, P.; Santos, M.L.; Costa, V.; Cunha, P.; Gonçalves, C.; Nunes, S.; Camões, J.; Adrião, D.; Oliveira, A.; Omrani, A.; Al Maslamani, M.; elbuzidi, A.S.; Al qudah, B.M.; Akkari, A.R.; Alkhatteb, M.; Baiou, A.; Husain, A.; Alwraidat, M.; Saif, I.A.; Bakdach, D.; Ahmed, A.; Aleef, M.; Bintaher, A.; Petrisor, C.; Popov, E.; Popova, K.; Dementienko, M.; Teplykh, B.; Pyregov, A.; Davydova, L.; Vladislav, B.; Neporada, E.; Zverev, I.; Meshchaninova, S.; Sokolov, D.; Gavrilova, E.; Shlyk, I.; Poliakov, I.; B?aco?a, M.; Aljuhani, O.; Alkhalaf, A.; Humaid, F.B.; Arabi, Y.; Kuhail, A.; Elrabi, O.; Alghnam, M.; Kansal, A.; Ho, V.K.; Ng, J.; García, R.R.; Fraga, X.T.; del Pilar García-Bonillo, M.; Padilla-Serrano, A.; Cuadrado, M.M.; Ferrando, C.; Catalan-Monzon, I.; Galarza, L.; Frutos-Vivar, F.; Jimenez, J.; Rodríguez-Solis, C.; Franquesa-Gonzalez, E.; Acosta, G.P.; Cabrera, L.S.; Parra, J.P.A.; Gonzalez, F.M.; del Carmen Lorente Conesa, M.; Varela, I.Y.M.; Pravia, O.V.B.; Delgado, M.C.M.; de Cabo, C.M.; Ioan, A.-M.; Perez-Calvo, C.; Santos, A.; Abad-Motos, A.; Ripolles-Melchor, J.; Martin, B.C.; Teruel, S.Y.; Lucas, J.H.; Ortiz, A.B.; de Pablo Sánchez, R.; Barrueco-Francioni, J.E.; Espina, L.F.; Bonell-Goytisolo, J.M.; Salaverria, I.; Mir, A.S.; Rodriguez-Ruiz, E.; Valverde, V.H.; Cubero, P.J.; Linde, F.A.; Leganes, N.C.; Romeu, J.M.; Concha, P.; Berezo-Garcia, J.A.; Fraile, V.; Cuenca-Rubio, C.; Perez-Torres, D.; Serrano, A.; Valero, C.M.; Suner, A.O.; Larrañaga, L.; Legaristi, N.; Ferrigno, G.; Khlafalla, S.; Bihariesingh-Sanchit, R.; Zoerner, F.; Grip, J.; Kilsand, K.; Österlind, J.; von Seth, M.; Berkius, J.; Ceruti, S.; Glotta, A.; Izdes, S.; Turan, I.Ö.; Cosar, A.; Halacli, B.; Dereli, N.; Yilmaz, M.; Akbas, T.; Elay, G.; Eyüpoglu, S.; Bílír, Y.; Saraçoglu, K.T.; Kaya, E.; Sahin, A.S.; Ekren, P.K.; Mengi, T.; Suner, K.O.; Tomak, Y.; Eroglu, A.; Alsabbah, A.; Hanlon, K.; Gervin, K.; McMahon, S.; Hagan, S.; Higenbottam, C.V.; Mullhi, R.; Poulton, L.; Torlinski, T.; Gareth, A.; Truman, N.; Vijayakumar, G.; Hall, C.; Cagova, L.; Jones, N.; Graham, S.; Robin, N.; Cowton, A.; Donnelly, A.; Singatullina, N.; Kent, M.; Boulanger, C.; Campbell, Z.; Potter, E.; Duric, N.; Szakmany, T.; Kviatkovske, O.; Marczin, N.; Ellis, C.; Saha, R.; Sri-Chandana, C.; Allan, J.; Mumelj, L.; Venkatesh, H.; Gotz, V.N.; Cochrane, A.; Lumlertgul, N.; Ficial, B.; Jain, S.; Crapelli, G.B.; Vlachou, A.; Golden, D.; Garrioch, S.; Henning, J.; Loveleena, G.; Davey, M.; Grauslyte, L.; Salciute-Simene, E.; Cook, M.; Barling, D.; Broadhurst, P.; Purvis, S.; Michael, S.; Shuker, B.; Grecu, I.; Harding, D.; Singatullina, N.; Dean, J.T.; Nielsen, N.D.; Al-Bayati, S.; Al-Sadawi, M.; Charron, M.; Stubenrauch, P.; Santanilla, J.; Wentowski, C.; Rosenberger, D.; Eksarko, P.; Jawa, R.; for the ESICM UNITE COVID investigators

doi:10.1186/s13054-022-04108-8

Μονάδα:

Ερευνητικό υλικό ΕΚΠΑ

Τίτλος:

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Γλώσσες Τεκμηρίου:

Αγγλικά

Περίληψη:

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients. Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson’s Chi-squared and continuous variables by Mann–Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the “full” matching method. Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO. Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). Graphical abstract: [Figure not available: see fulltext.]. © 2022, The Author(s).

Έτος δημοσίευσης:

2022

Συγγραφείς:

Conway Morris, A.
Kohler, K.
De Corte, T.
Ercole, A.
De Grooth, H.-J.
Elbers, P.W.G.
Povoa, P.
Morais, R.
Koulenti, D.
Jog, S.
Nielsen, N.
Jubb, A.
Cecconi, M.
De Waele, J.
Bezzi, M.
Gira, A.
Eller, P.
Hamid, T.
Haque, I.U.
De Buyser, W.
Cudia, A.
De Backer, D.
Foulon, P.
Collin, V.
Van Hecke, J.
De Waele, E.
Van Malderen, C.
Mesland, J.-B.
Piagnerelli, M.
Haentjens, L.
De Schryver, N.
Van Leemput, J.
Vanhove, P.
Bulpa, P.
Ilieva, V.
Katz, D.
Geagea, A.
Binnie, A.
Tirapegui, F.
Lago, G.
Graf, J.
Perez-Araos, R.
Vargas, P.
Martinez, F.
Labarca, E.
Franco, D.M.
Parra-Tanoux, D.
Reyes, L.F.
Yepes, D.
Periš, F.
Stipic, S.S.
Burgos, C.V.C.
Boada, P.R.N.
Brun, J.L.B.
Ballesteros, J.P.P.
Hammouda, A.
Elmandouh, O.
Azzam, A.
Hussein, A.M.
Galal, I.
Awad, A.K.
Azab, M.A.
Abdalla, M.
Assal, H.
Alfishawy, M.
Ghozy, S.
Tharwat, S.
Eldaly, A.
Reinhard, V.
Chrisment, A.
Poyat, C.
Badie, J.
Ferrari, F.B.
Weiss, B.
Kuhn, K.F.
Grunow, J.J.
Lorenz, M.
Schaller, S.
Spieth, P.
Bota, M.
Fichtner, F.
Fuest, K.
Lahmer, T.
Herrmann, J.
Meybohm, P.
Markou, N.
Vasileiadou, G.
Chrysanthopoulou, E.
Papamichalis, P.
Soultati, I.
Kalvit, K.
Myatra, S.N.
Krupa, I.
Tharwat, A.
Nichol, A.
McCarthy, A.
Mahmoodpoor, A.
Tonetti, T.
Isoni, P.
Spadaro, S.
Volta, C.A.
Mirabella, L.
Noto, A.
Florio, G.
Guzzardella, A.
Paleari, C.
Baccanelli, F.
Savi, M.
Antonelli, M.
Vaccarini, B.
Montrucchio, G.
Sales, G.
Donadello, K.
Gottin, L.
Polati, E.
De Rosa, S.
Sulemanji, D.
Abusalama, A.
Elhadi, M.
De Jesus, M.F.
Gonzalez, D.R.
Canedo, N.
Chavez, A.E.
Dendane, T.
Grady, B.
de Jong, B.
van der Heiden, E.
Thoral, P.
van den Bogaard, B.
Spronk, P.E.
Achterberg, S.
Groeneveld, M.
So, R.K.L.
de Wijs, C.
Scholten, H.
Beishuizen, A.
Cornet, A.D.
Reidinga, A.C.
Kranen, H.
Mensink, R.
Boer, S.
de Groot, M.
Beck, O.
Bethlehem, C.
van Bussel, B.
Frenzel, T.
de Jong, C.
Wilting, R.
Kesecioglu, J.
Mehagnoul-Schipper, J.
Alasia, D.
Kumar, A.
Qayyum, A.
Rana, M.
Jayyab, M.A.
Sierra, R.Q.
Hernandez, A.M.
Taborda, L.
Ramires, T.
Silva, C.
Roriz, C.
Patricio, P.
Santos, M.L.
Costa, V.
Cunha, P.
Gonçalves, C.
Nunes, S.
Camões, J.
Adrião, D.
Oliveira, A.
Omrani, A.
Al Maslamani, M.
elbuzidi, A.S.
Al qudah, B.M.
Akkari, A.R.
Alkhatteb, M.
Baiou, A.
Husain, A.
Alwraidat, M.
Saif, I.A.
Bakdach, D.
Ahmed, A.
Aleef, M.
Bintaher, A.
Petrisor, C.
Popov, E.
Popova, K.
Dementienko, M.
Teplykh, B.
Pyregov, A.
Davydova, L.
Vladislav, B.
Neporada, E.
Zverev, I.
Meshchaninova, S.
Sokolov, D.
Gavrilova, E.
Shlyk, I.
Poliakov, I.
B?aco?a, M.
Aljuhani, O.
Alkhalaf, A.
Humaid, F.B.
Arabi, Y.
Kuhail, A.
Elrabi, O.
Alghnam, M.
Kansal, A.
Ho, V.K.
Ng, J.
García, R.R.
Fraga, X.T.
del Pilar García-Bonillo, M.
Padilla-Serrano, A.
Cuadrado, M.M.
Ferrando, C.
Catalan-Monzon, I.
Galarza, L.
Frutos-Vivar, F.
Jimenez, J.
Rodríguez-Solis, C.
Franquesa-Gonzalez, E.
Acosta, G.P.
Cabrera, L.S.
Parra, J.P.A.
Gonzalez, F.M.
del Carmen Lorente Conesa, M.
Varela, I.Y.M.
Pravia, O.V.B.
Delgado, M.C.M.
de Cabo, C.M.
Ioan, A.-M.
Perez-Calvo, C.
Santos, A.
Abad-Motos, A.
Ripolles-Melchor, J.
Martin, B.C.
Teruel, S.Y.
Lucas, J.H.
Ortiz, A.B.
de Pablo Sánchez, R.
Barrueco-Francioni, J.E.
Espina, L.F.
Bonell-Goytisolo, J.M.
Salaverria, I.
Mir, A.S.
Rodriguez-Ruiz, E.
Valverde, V.H.
Cubero, P.J.
Linde, F.A.
Leganes, N.C.
Romeu, J.M.
Concha, P.
Berezo-Garcia, J.A.
Fraile, V.
Cuenca-Rubio, C.
Perez-Torres, D.
Serrano, A.
Valero, C.M.
Suner, A.O.
Larrañaga, L.
Legaristi, N.
Ferrigno, G.
Khlafalla, S.
Bihariesingh-Sanchit, R.
Zoerner, F.
Grip, J.
Kilsand, K.
Österlind, J.
von Seth, M.
Berkius, J.
Ceruti, S.
Glotta, A.
Izdes, S.
Turan, I.Ö.
Cosar, A.
Halacli, B.
Dereli, N.
Yilmaz, M.
Akbas, T.
Elay, G.
Eyüpoglu, S.
Bílír, Y.
Saraçoglu, K.T.
Kaya, E.
Sahin, A.S.
Ekren, P.K.
Mengi, T.
Suner, K.O.
Tomak, Y.
Eroglu, A.
Alsabbah, A.
Hanlon, K.
Gervin, K.
McMahon, S.
Hagan, S.
Higenbottam, C.V.
Mullhi, R.
Poulton, L.
Torlinski, T.
Gareth, A.
Truman, N.
Vijayakumar, G.
Hall, C.
Cagova, L.
Jones, N.
Graham, S.
Robin, N.
Cowton, A.
Donnelly, A.
Singatullina, N.
Kent, M.
Boulanger, C.
Campbell, Z.
Potter, E.
Duric, N.
Szakmany, T.
Kviatkovske, O.
Marczin, N.
Ellis, C.
Saha, R.
Sri-Chandana, C.
Allan, J.
Mumelj, L.
Venkatesh, H.
Gotz, V.N.
Cochrane, A.
Lumlertgul, N.
Ficial, B.
Jain, S.
Crapelli, G.B.
Vlachou, A.
Golden, D.
Garrioch, S.
Henning, J.
Loveleena, G.
Davey, M.
Grauslyte, L.
Salciute-Simene, E.
Cook, M.
Barling, D.
Broadhurst, P.
Purvis, S.
Michael, S.
Shuker, B.
Grecu, I.
Harding, D.
Singatullina, N.
Dean, J.T.
Nielsen, N.D.
Al-Bayati, S.
Al-Sadawi, M.
Charron, M.
Stubenrauch, P.
Santanilla, J.
Wentowski, C.
Rosenberger, D.
Eksarko, P.
Jawa, R.
for the ESICM UNITE COVID investigators

Περιοδικό:

Critical care explorations

Εκδότης:

BioMed Central Ltd.

Τόμος:

Αριθμός / τεύχος:

Λέξεις-κλειδιά:

antibiotic agent; corticosteroid; antiinfective agent, adult; aged; antibiotic therapy; Article; bacterial pneumonia; cohort analysis; coinfection; confounding variable; controlled study; coronavirus disease 2019; critically ill patient; disease surveillance; drug use; female; hospital admission; hospital infection; human; intensive care unit; long term care; lung mycosis; major clinical study; male; observational study; pandemic; polymerase chain reaction; treatment duration; bacterial pneumonia; clinical trial; coinfection; complication; critical illness; intensive care unit; multicenter study; virus pneumonia, Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Coinfection; COVID-19; COVID-19 Testing; Critical Illness; Humans; Intensive Care Units; Pandemics; Pneumonia, Bacterial; Pneumonia, Viral

Επίσημο URL (Εκδότης):

https://doi.org/10.1186/s13054-022-04108-8

DOI:

10.1186/s13054-022-04108-8

Μόνιμη διεύθυνση:

https://pergamos.lib.uoa.gr/uoa/dl/object/3347515

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

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