Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

  title={Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units},
  author={Despoina Koulenti and Thiago Lisboa and Christian Brun-Buisson and Wolfgang A. Krueger and Antonio Macor and Jordi Sol{\'e}-Viol{\'a}n and Emili D{\'i}az and Arzu Topeli and J Dewaele and A. Carneiro and Ignacio Mart{\'i}n-Loeches and Apostolos Armaganidis and Jordi Rello},
  journal={Critical Care Medicine},
Objectives:Information on clinical practice regarding the diagnosis of pneumonia in European intensive care units is limited. The aim of this study was to describe the spectrum of actual diagnostic practices in a large sample of European intensive care units. Design:Prospective, observational, multicenter study. Setting:Twenty-seven intensive care units of nine European countries. Patients:Consecutive patients requiring invasive mechanical ventilation for an admission diagnosis of pneumonia or… 
Determinants of prescription and choice of empirical therapy for hospital-acquired and ventilator-associated pneumonia
Across Europe, carbapenems were the antibiotic most prescribed for HAP/VAP, and appropriate empirical antibiotics decreased ICU length of stay by 6 days, which was the major determinants of antibiotic choice at the bedside.
Bacteremia is an independent risk factor for mortality in nosocomial pneumonia: a prospective and observational multicenter study
B-NP episodes are more frequent in patients with medical admission, MRSA and A. baumannii etiology and prolonged mechanical ventilation, and are independently associated with higher mortality rates.
ICU-Acquired Pneumonia With or Without Etiologic Diagnosis: A Comparison of Outcomes*
Although the possible influence of previous intubation in mortality of both groups is not completely discarded, negative microbiologic findings in clinically suspected ICU-acquired pneumonia are associated with less frequent previous intubes, shorter duration of antimicrobial treatment, and better survival.
Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study
In conclusion, NP management in Europe presents local differences and major shifts when compared to reports from North America, outcomes of randomized trials and general guidelines.
The incidence and characteristics of ventilator-associated pneumonia in a regional nontertiary Australian intensive care unit: A retrospective clinical audit study.
Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia
Patients with severe community-acquired pneumonia had a low adherence with the 2007 IDSA/ATS guidelines and Combination therapy with macrolides should be preferred in intubated patients with severe CAP.
Impact of ventilator-associated pneumonia on mortality and epidemiological features of patients with secondary peritonitis
In light of the impact of nosocomial infections on morbidity and mortality in the ICU, more attention should be given to the concurrent features among VAP and secondary peritonitis.
Assessment of Severity of ICU-Acquired Pneumonia and Association With Etiology
In patients with ICU-acquired pneumonia, severity of illness seems not to affect etiology, and risk factors for multidrug resistant, but not severity of illnesses, should be taken into account in selecting empiric antimicrobial treatment.
The Distribution of Multidrug-resistant Microorganisms and Treatment Status of Hospital-acquired Pneumonia/Ventilator-associated Pneumonia in Adult Intensive Care Units: a Prospective Cohort Observational Study
There was a large burden of MDR pathogens, and their associated mortality rate was high in HAP/VAP patients, and proper selection of empirical antibiotics was significantly associated with the patient's prognosis; however, there was a discrepancy between major pathogens and empirical antibiotic therapy.


The Spectrum of Practice in the Diagnosis and Management of Pneumonia in Patients Requiring Mechanical Ventilation. Australian and New Zealand Practice in Intensive Care (ANZPIC II)
There is practice variability in bronchoscopy and antibiotic use for pneumonia in Australian and New Zealand ICUs without significant impact on patient outcome, as the prevalence of inappropriate antibiotic prescription is low.
Prognostic factors of pneumonia requiring admission to the intensive care unit.
All patients with severe pneumonias (community-acquired and nosocomial) who required treatment in the intensive care unit (ICU) were included in a 3-year prospective study. Predictive factors for a
Nosocomial Pneumonia on General Medical and Surgical Wards in a Tertiary-Care Hospital
Although the morbidity of nosocomial pneumonia in this population was high, as evidenced by high rates of transfer to ICU, the directly associated mortality was relatively low and interventions to prevent pneumonia or to improve prognosis may not be feasible.
Early onset pneumonia: a multicenter study in intensive care units
A suggested pathogenetic mechanism is aspiration of oropharyngeal contents at the onset of acute illness, due to depression of protective reflexes with delayed clearance of bacterial contamination, which was offered by routinely applied prophylactic antibiotic therapy.
Incidence and risk factors of pneumonia acquired in intensive care units
The role of the injury to the respiratory system — with the subsequent need for respiratory support-appears central in determining the risk to acquire pneumonia in ICU and the predictive value of severity scores during ICU course should be assessed.
The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee.
ICU-acquired infection is common and often associated with microbiological isolates of resistant organisms, and the potential effects on outcome emphasize the importance of specific measures for infection control in critically ill patients.
Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients.
It is concluded that nosocomial pneumonia is a frequent complication of MV in the medical-surgical ICU, and significantly prolongs the length of stay in the ICU for survivors.
Pneumonia in the intensive care unit
ObjectiveTo update the state-of-the-art on pneumonia in adult patients in the intensive care unit (ICU), with special emphasis on new developments in management. MethodsWe searched MEDLINE, using the
Impact of Ventilator-Associated Pneumonia on Resource Utilization and Patient Outcome
Ventilator-associated pneumonia negatively affects patient outcome and represents a significant burden on intensive care unit and hospital resources.