French national epidemiology of bacterial superinfections in ventilator-associated pneumonia in patients infected with COVID-19: the COVAP study
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Description and comparison of bacterial characteristics of ventilator-associated pneumonia (VAP) between critically ill intensive care unit (ICU) patients with COVID-19-positive, COVID + ; and non-COVID-19, COVID-. METHODS: Retrospective, observational, multicenter study that focused on French patients during the first wave of the pandemic (March-April 2020). RESULTS: 935 patients with identification of at least one bacteriologically proven VAP were included (including 802 COVID +). Among Gram-positive bacteria, S. aureus accounted for more than two-thirds of the bacteria involved, followed by Streptococcaceae and enterococci without difference between clinical groups regarding antibiotic resistance. Among Gram-negative bacteria, Klebsiella spp. was the most frequently observed bacterial genus in both groups, with K. oxytoca overrepresented in the COVID- group (14.3% vs. 5.3%; p < 0.05). Cotrimoxazole-resistant bacteria were over-observed in the COVID + group (18.5% vs. 6.1%; p <0.05), and after stratification for K. pneumoniae (39.6% vs. 0%; p <0.05). In contrast, overrepresentation of aminoglycoside-resistant strains was observed in the COVID- group (20% vs. 13.9%; p < 0.01). Pseudomonas sp. was more frequently isolated from COVID + VAPs (23.9% vs. 16.7%; p <0.01) but in COVID- showed more carbapenem resistance (11.1% vs. 0.8%; p <0.05) and greater resistance to at least two aminoglycosides (11.8% vs. 1.4%; p < 0.05) and to quinolones (53.6% vs. 7.0%; p <0.05). These patients were more frequently infected with multidrug-resistant bacteria than COVID + (40.1% vs. 13.8%; p < 0.01). CONCLUSIONS: The present study demonstrated that the bacterial epidemiology and antibiotic resistance of VAP in COVID + is different from that of COVID- patients. These features call for further study to tailor antibiotic therapies in VAP patients.
Authors: Maxime Pichon, Julie Cremniter, Christophe Burucoa, the COVAP Study group, Sahar Abdallah, Corentine Alauzet, Tom Alix, Kahina Allouche, Marlène Amara, Florence Anglade, Nadia Anguel, Laurence Armand-Lefevre, Francois Barbier, Clémence Beauruelle, Pascale Bemer, Hanaa Benmansour, Béatrice Bercot, Ludovic Bergon, Dominique Bertei, Marc Berthon, Pascal Beuret, Léa Bientz, Laura Billon, Aurore Bousquet, Amélie Brousse, Lauranne Broutin, Fabrice Bruneel, Anne Cady, Francois Camelena, Amélie Carrer-Causeret, Yvan Caspar, Lotfi Chemali, Anne Christine Jaouen, Théophile Cocherie, Aurélie Cointe, Stephane Corvec, Laura Courtellemont, Gaelle Cuzon, Anne Dao, Agathe Delbove, Camille D’Humieres, Laura Djamdjian, Alexandra Doloy, Joséphine Dorin, Yann Dumont, Bruno Dumoulard, Faten El Sayed, Marie-Sarah Fangous, Laurent Favier, Alexis Ferre, Nicolas Fortineau, Juliette Francois, Clémence Gachet, Mahmoud Gargouri, Denis Garot, Nabil Gastli, Elena Gauvin, Isabelle Geneau, Guillaume Geslain, Antoine Goury, Romaric Grenot, Antoine Grillon, Thomas Guillard, Aurélie Guillouzouic, Jerome Guinard, Jennifer Guiraud, Esther Gyde, Christophe Henry, Katy Jeannot, Marie Kempf, Achille Kouatchet, Luce Landraud, Philippe Lanotte, Sebastien Larreche, Brice Le Gallou, Elodie Le Breton, Pierre-Etienne Leblanc, Hervé Lecuyer, Ludovic Lemee, Pauline Lessard, David Leyssene, Pierre Lureau, Anne-Elisabeth Manteaux, Michael Mervent, Maite Micaelo, Anthony Michaud, Olivier Moquet, Anaelle Muggeo, Evelina Ochin, Patrick Ochocki, Abdelali Ouchikhe, Maxime Paluch, Marie Pancher-Lory, Alix Pantel, Adeline Pastuszka, Ophélie Perruche, Olivia Peuchant, Caroline Piau, Chloé Plouzeau-Jayle, Kevin Quesnel, Lucie Richard, Emeline Riverain, Alexandre Robert, Anne-Laure Roux, Pierre Saint-Sardos, Laurent Serpin, Daniel Silva, Valerie Sivadon-Tardy, Karim Toumert, Céline Tournus, Pauline Touroult-Jupin, Antoine Tran Quy, Anne Vachee, Christian Vanjak, Véronique Vernet-Garnier, Camille Vinclair, Jérémie Violette, Violaine Walewski
Institutions: Inserm, Université de Poitiers, Centre Hospitalier Universitaire de Poitiers, Pharmacologie des anti-infectieux et antibiorésistance, Biologie & Santé, Centre Hospitalier Régional et Universitaire de Nancy, Stress, IMmunité, PAthogènes, Université de Lorraine, Assistance Publique – Hôpitaux de Paris, Bicêtre Hospital, Hôpital Bichat-Claude-Bernard, Université Paris Diderot, Infection, Anti-microbiens, Modélisation, Evolution, Centre hospitalier universitaire d'Orléans, Centre Hospitalier Régional Universitaire de Brest, Génétique, Génomique Fonctionnelle et Biotechnologies, Centre Hospitalier Universitaire de Nantes, Nantes Université, Université Paris Cité, Hôpital Fernand-Widal, Hôpital Lariboisière, Hôpital Saint-Louis, Hôpital Robert-Debré
Language: English
Topic: Nosocomial Infections in ICU
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,990
OpenAlex ID: W4382399752