Invasiveness of Ventilation Therapy Is Associated to Prevalence of Secondary Bacterial and Fungal Infections in Critically Ill COVID-19 Patients

被引:11
作者
de Hesselle, Marie Louise [1 ]
Borgmann, Stefan [2 ]
Rieg, Siegbert [3 ]
Vehreshild, Jorg Janne [4 ,5 ,6 ,7 ]
Spinner, Christoph D. [8 ,9 ]
Koll, Carolin E. M. [5 ,6 ,7 ]
Hower, Martin [10 ]
Stecher, Melanie [5 ,6 ,7 ]
Ebert, Daniel [1 ]
Hanses, Frank [11 ,12 ]
Schumann, Julia [1 ]
机构
[1] Univ Med Halle Salle, Univ Clin & Outpatient Clin Anesthesiol & Operat, D-06112 Halle, Salle, Germany
[2] Ingolstadt Hosp, Dept Infect Dis & Infect Control, D-85049 Ingolstadt, Germany
[3] Univ Freiburg, Dept Med 2, D-79106 Freiburg, Germany
[4] Goethe Univ Frankfurt, Dept Internal Med Hematol & Oncol 2, D-60323 Frankfurt, Germany
[5] Univ Cologne, Fac Med, Ctr Integrated Oncol Aachen Bonn Cologne Duesseld, Dept Internal Med, D-50931 Cologne, Germany
[6] Univ Cologne, Univ Hosp Cologne, D-50931 Cologne, Germany
[7] German Ctr Infect Res DZIF, Partner Site Bonn Cologne, D-50937 Cologne, Germany
[8] Tech Univ Munich, Univ Hosp Rechts Der Isar, Sch Med, Dept Internal Med 2, D-81675 Munich, Germany
[9] German Ctr Infection Res DZIF, D-38106 Braunschweig, Germany
[10] Klinikum Dortmund GmbH, Dept Pneumol Infect Dis Internal Med & Intens Car, D-44137 Dortmund, Germany
[11] Univ Hosp Regensburg, Emergency Dept, D-93053 Regensburg, Germany
[12] Univ Hosp Regensburg, Dept Infect Control & Infect Dis, D-93053 Regensburg, Germany
关键词
COVID-19; SARS-CoV-2; multidrug-resistant pathogens; bacterial infections; fungal infections; secondary infections; intensive care medicine; ventilation; ECMO; COINFECTION; INFLUENZA; PATHOGENESIS; VIRUS; CARE;
D O I
10.3390/jcm11175239
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Superinfections are a fundamental critical care problem, and their significance in severe COVID-19 cases needs to be determined. This study analyzed data from the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort focusing on intensive care patients. A retrospective analysis of patient data from 840 cases of COVID-19 with critical courses demonstrated that co-infections were frequently present and were primarily of nosocomial origin. Furthermore, our analysis showed that invasive therapy procedures accompanied an increased risk for healthcare-associated infections. Non-ventilated ICU patients were rarely affected by secondary infections. The risk of infection, however, increased even when non-invasive ventilation was used. A further, significant increase in infection rates was seen with the use of invasive ventilation and even more so with extracorporeal membrane oxygenation (ECMO) therapy. The marked differences among ICU techniques used for the treatment of COVID-19-induced respiratory failure in terms of secondary infection risk profile should be taken into account for the optimal management of critically ill COVID-19 patients, as well as for adequate antimicrobial therapy.
引用
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页数:13
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