TY - JOUR T1 - Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01656-2017 SP - 1701656 AU - Anne-Sophie Moreau AU - Ignacio Martin-Loeches AU - Pedro Povoa AU - Jorge Salluh AU - Alejandro Rodriguez AU - Arnaud W Thille AU - Emilio Diaz Santos AU - Elisa Vedes AU - Suzana Margareth Lobo AU - Bruno Mégarbane AU - Esperanza Molero Silvero AU - Luis Coelho AU - Laurent Argaud AU - Rafael Sanchez Iniesta AU - Julien Labreuche AU - Anahita Rouzé AU - Saad Nseir A2 - , Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/01/18/13993003.01656-2017.abstract N2 - The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower in immunocompromised than in non-immunocompromised patients (16.6% versus 24.2%, p<0.0001, Subhazard ratio 0.65 (0.53–0.80)). Similar results were found regarding ventilator-associated tracheobronchitis (VAT) (7.3% versus 11.6%, p=0.002, 0.61 (0.45–0.84)), and ventilator-associated pneumonia (VAP) (9.3% versus 12.7%, p=0.019, 0.72 (0.54–0.95)). Among patients with VA-LRTI, the rates of multidrug resistant (MDR) bacteria (72% versus 59%, p=0.011), and ICU mortality were significantly higher in immunocompromised compared with non-immunocompromised patients (54%, versus 30%, p<0.0001, OR 2.68 (95% CI 1.78–4.02)). In patients with VAP, mortality rates were higher in immunocompromised than in non-immunocompromised patients (64% versus 34%, p<0.001).Incidence of VA-LRTI was significantly lower in immunocompromised compared with non-immunocompromised patients, but it was associated with significantly higher mortality rate. MDR pathogens were more frequently found in immunocompromised patients with VA-LRTI.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. MOREAU has nothing to disclose.Conflict of interest: Dr. Martin-loeches has nothing to disclose.Conflict of interest: Pedro PovoaConflict of interest: Dr. Salluh has nothing to disclose.Conflict of interest: Alejandro RodriguezConflict of interest: Dr. Thille has nothing to disclose.Conflict of interest: Dr. Diaz Santos has nothing to disclose.Conflict of interest: Dr. Vedes has nothing to disclose.Conflict of interest: Suzana Margareth LoboConflict of interest: Bruno MegarbaneConflict of interest: Dr. Molero Silvero has nothing to disclose.Conflict of interest: Dr. Coelho has nothing to disclose.Conflict of interest: Dr. Argaud has nothing to disclose.Conflict of interest: Dr. SANCHEZ INIESTA has nothing to disclose.Conflict of interest: Dr. Labreuche has nothing to disclose.Conflict of interest: Dr. Rouzé has nothing to disclose.Conflict of interest: Dr. Nseir reports personal fees from Bayer, personal fees from Ciel Medical, personal fees from MSD, personal fees from Medtronic, outside the submitted work.Conflict of interest: Dr. Lobo has nothing to disclose.Conflict of interest: Dr. Rodriguez has nothing to disclose. ER -