PT  - JOURNAL ARTICLE
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
ED  - ,
TI  - Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections
AID  - 10.1183/13993003.01656-2017
DP  - 2018 Mar 01
TA  - European Respiratory Journal
PG  - 1701656
VI  - 51
IP  - 3
4099  - http://erj.ersjournals.com/content/51/3/1701656.short
4100  - http://erj.ersjournals.com/content/51/3/1701656.full
SO  - Eur Respir J2018 Mar 01; 51
AB  - 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 among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53–0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45–0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54–0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78–4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.Ventilator-associated lower respiratory tract infections are less common in immunocompromised patients http://ow.ly/p4Ew30ia2fO