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Microbiological vs non-microbiological confirmed nnventilator ICU-acquired pneumonia

Tarek Senussi Testa, Francesco A. Idone, Adrian Ceccato, Miquel Ferrer, Gianluigi Li Bassi, Otavio T Ranzani, Albert Gabarrus, Juan Rosselló Sancho, Antoni Torres
European Respiratory Journal 2016 48: PA2636; DOI: 10.1183/13993003.congress-2016.PA2636
Tarek Senussi Testa
1Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino-IST, Genova, Italy
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Francesco A. Idone
2Department of Anesthesiology and Intensive Care, Hopsital “A. Gemelli”, Catholic University of the Sacred Heart, Rome, Italy
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Adrian Ceccato
3Neurología, Hospital Nacional Prof. Alejandro Posadas, Palomar, Argentina
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Miquel Ferrer
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Gianluigi Li Bassi
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Otavio T Ranzani
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Albert Gabarrus
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Juan Rosselló Sancho
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Antoni Torres
4Institut Clínic del Tòrax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Abstract

Introduction: Nonventilator ICU-acquired pneumonia (NV-ICUAP), is the leading infection in critically ill patients. We evaluated retrospectively how the diagnosis of NV-ICUAP has been done in our hospital, proportion of NV-ICUAP with an etiologic diagnosis and the differences between Microbiological-Defined(MicDef) and Not Defined (MicNotDef) groups. The aim of this study was to evaluate the importance of an early microbiological definition to guide the therapy.

Methods: Data were prospectively collected in 6 ICUs (overall 45 beds) between 2007 and 2015.MicDef and MicNotDef NV-ICUAP at diagnosis were retrospectively compared according to identify: diagnostic methods, therapy, outcomes and inflammatory response.

Results: We studied 194 NV-ICUAP. Patients were clustered in two groups: MicDef 82(42%) and MicNotDef 112(58%). Both groups had similar baseline severity scores and initial systemic inflammatory response. The MicNotDef group had less Endotracheal Intubations (ETI)(54.5 vs 69,5%;p=0.034), shorter total duration of antimicrobials(ATBs) (Mean 13 days SD±6vs17 days SD±12;p=0.006) and shorter ICU stay (17.3±20.5 vs 20,9±16,3;p=0.004) than positive MicDef. The overall mortality was 42%, non significant difference was observed between groups (48% vs 38%;p=0.14) and was higher among patients with inadequate empirical treatment according with microbiologic isolation (84% vs 42%;p= 0.006).

Conclusions: Interestingly we found that MicNotDef patients had a shorter duration of ATBs treatment stayed less in the ICU and had less ETI events. Patients treated with an adequate empiric therapy (according the antibiogram) have a better survival than patients with an inadequate treatment in MicDef group.

  • Intensive care
  • Pneumonia
  • Infections
  • Copyright ©the authors 2016
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Microbiological vs non-microbiological confirmed nnventilator ICU-acquired pneumonia
Tarek Senussi Testa, Francesco A. Idone, Adrian Ceccato, Miquel Ferrer, Gianluigi Li Bassi, Otavio T Ranzani, Albert Gabarrus, Juan Rosselló Sancho, Antoni Torres
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2636; DOI: 10.1183/13993003.congress-2016.PA2636

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Microbiological vs non-microbiological confirmed nnventilator ICU-acquired pneumonia
Tarek Senussi Testa, Francesco A. Idone, Adrian Ceccato, Miquel Ferrer, Gianluigi Li Bassi, Otavio T Ranzani, Albert Gabarrus, Juan Rosselló Sancho, Antoni Torres
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2636; DOI: 10.1183/13993003.congress-2016.PA2636
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