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Journal Articles Scientific Reports Year : 2021

Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia

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Laurent Zieleskiewicz
Karine Baumstarck
  • Function : Author
Anne Savey
  • Function : Author
Serge Alfandari
  • Function : Author
Sébastien Bailly
Odile Bajolet
  • Function : Author
Olivier Baldesi
  • Function : Author
Anne Berger-Carbonne
  • Function : Author
Pierre-Edouard Bollaert
  • Function : Author
  • PersonId : 772611
  • IdRef : 059868732
Cedric Bretonniere
  • Function : Author
Céline Chatelet
  • Function : Author
Philippe Corne
  • Function : Author
Isabelle Durand-Joly
  • Function : Author
Arnaud Friggeri
  • Function : Author
Gaëlle Gasan
  • Function : Author
Rémy Gauzit
  • Function : Author
Marine Giard
  • Function : Author
Caroline Landelle
Thierry Lavigne
  • Function : Author
Didier Lepelletier
  • Function : Author
Pierre-François Perrigault
  • Function : Author
Santiago Picos
  • Function : Author
Marie-Aline Robaux
  • Function : Author
Vincent Stoeckel
  • Function : Author
Jean-François Timsit
Philippe Vanhems
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  • PersonId : 759616
  • IdRef : 061621196

Abstract

Abstract Data on the relationship between antimicrobial resistance and mortality remain scarce, and this relationship needs to be investigated in intensive care units (ICUs). The aim of this study was to compare the ICU mortality rates between patients with ICU-acquired pneumonia due to highly antimicrobial-resistant (HAMR) bacteria and those with ICU-acquired pneumonia due to non-HAMR bacteria. We conducted a multicenter, retrospective cohort study using the French National Surveillance Network for Healthcare Associated Infection in ICUs (“REA-Raisin”) database, gathering data from 200 ICUs from January 2007 to December 2016. We assessed all adult patients who were hospitalized for at least 48 h and presented with ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii . The association between pneumonia caused by HAMR bacteria and ICU mortality was analyzed using the whole sample and using a 1:2 matched sample. Among the 18,497 patients with at least one documented case of ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii , 3081 (16.4%) had HAMR bacteria. The HAMR group was associated with increased ICU mortality (40.3% vs. 30%, odds ratio (OR) 95%, CI 1.57 [1.45–1.70], P < 0.001). This association was confirmed in the matched sample (3006 HAMR and 5640 non-HAMR, OR 95%, CI 1.39 [1.27–1.52], P < 0.001) and after adjusting for confounding factors (OR ranged from 1.34 to 1.39, all P < 0.001). Our findings suggest that ICU-acquired pneumonia due to HAMR bacteria is associated with an increased ICU mortality rate, ICU length of stay, and mechanical ventilation duration.

Dates and versions

hal-03429611 , version 1 (15-11-2021)

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Cite

Ines Lakbar, Sophie Medam, Romain Ronflé, Nadim Cassir, Louis Delamarre, et al.. Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia. Scientific Reports, 2021, 11 (1), ⟨10.1038/s41598-021-95852-4⟩. ⟨hal-03429611⟩
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