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French national epidemiology of bacterial superinfections in ventilator-associated pneumonia in patients infected with COVID-19: the COVAP study

2023; BioMed Central; Volume: 22; Issue: 1 Linguagem: Inglês

10.1186/s12941-023-00603-0

1476-0711

Maxime Pichon, Julie Cremniter, Christophe Burucoa, Sahar Abdallah, Corentine Alauzet, Tom Alix, Kahina Allouche, Marlène Amara, Florence Anglade, Nadia Anguel, Laurence Armand-Lefèvre, François Barbier, Clémence Beauruelle, Pascale Bémer, Hanaa Benmansour, Béatrice Berçot, Ludovic Bergon, Dominique Bertei, Marc Berthon, Pascal Beuret, Léa Bientz, Laura Billon, Aurore Bousquet, A Brousse, Lauranne Broutin, Fabrice Bruneel, Anne Cady, François Caméléna, Amélie Carrër-Causeret, Yvan Caspar, Lotfi Chemali, Anne Christine Jaouen, Théophile Cocherie, Aurélie Cointe, Stéphane Corvec, Laura Courtellemont, Gaëlle Cuzon, Anne Dao, Agathe Delbove, Camille d’Humières, Laura Djamdjian, Alexandra Doloy, Joséphine Dorin, Yann Dumont, Bruno Dumoulard, Faten El Sayed, Marie-Sarah Fangous, Laurent Favier, Alexis Ferre, Nicolas Fortineau, Juliette François, Clémence Gachet, Mahmoud Gargouri, Denis Garot, Nabil Gastli, Elena Gauvin, Isabelle Geneau, Guillaume Geslain, Antoine Goury, Romaric Grenot, Antoine Grillon, Thomas Guillard, A. Guillouzouic, Jérôme Guinard, Jennifer Guiraud, Esther Gydé, C Henry, Katy Jeannot, Marie Kempf, Achille Kouatchet, Luce Landraud, Philippe Lanotte, Sébastien Larréché, Brice Le Gallou, Élodie Breton, Pierre-Étienne Leblanc, Hervé Lecuyer, Ludovic Lemée, Pauline Lessard, David Leyssene, Pierre Lureau, Anne-Elisabeth Manteaux, Michael Mervent, Maïté Micaëlo, Anthony Michaud, Olivier Moquet, Anaëlle Muggeo, Evelina Ochin, Patrick Ochocki, A. 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, Valérie Sivadon‐Tardy, Karim Toumert, Céline Tournus, Pauline Touroult-Jupin, Antoine Tran Quy, Anne Vachée, Christian Vanjak, Véronique Vernet-Garnier, Camille Vinclair, Jérémie Violette, Violaine Walewski,

Antibiotic Use and Resistance

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.