The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Ventilation, VAP, 【초록키워드】 coronavirus disease, Diseases, intensive care unit, ICU, Retrospective study, Critically ill, Culture, Impact, Patient, incidence rate, Septic shock, predictor, multicenter, prognostic, COVID-19 patients, Bacterial, acute respiratory distress, fatality, Pseudomonas aeruginosa, Staphylococcus aureus, Odds ratio, COVID-19 patient, Ventilator-associated pneumonia, confidence interval, ventilator, 95% CI, syndrome, multivariable analysis, organism, positive, event, deep, 【제목키워드】 multicenter study, Ill,