ArticleAnnals of intensive care2020
Ventilator-associated pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 3 of them syntheses that pooled it.
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Who cites it
83 citing papers in PubMed, 3 syntheses or guidelines pooled it, 180 citations in OpenAlex.
- Antimicrobial resistance in patients with COVID-19: a systematic review and meta-analysis.The Lancet. Microbe · 2023Pooled it
- ECMO in COVID-19 Patients: A Systematic Review and Meta-analysis.Journal of cardiothoracic and vascular anesthesia · 2022Pooled it
- A systematic review and meta-analysis comparing the clinical characteristics and outcomes of COVID-19 and influenza patients on ECMO.Respiratory investigation · 2021Pooled it
- Article
- Comparison between the antimicrobial activity of colistin and ceftazidime-avibactam against multidrug-resistant Pseudomonas aeruginosa isolated from patients with ventilator-associated pneumonia in intensive care units of Kasr Al-Ainy hospitals.BMC infectious diseases · 2026Observational
- The Resistance Paradox in COVID-19 Ventilator-Associated Pneumonia: A Retrospective Study on Rapid Molecular Stewardship.Antibiotics (Basel, Switzerland) · 2026Article
- The hospital length of stay and mortality and its risk and protective factors among patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
- Retrospective cohort study of adult patients with cystic fibrosis supported with venovenous extracorporeal membrane oxygenation (VV ECMO) at a large German cystic fibrosis center.BMC pulmonary medicine · 2025Article
- Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study.Tropical medicine and infectious disease · 2025Article
- A consensus of European experts on the definition of ventilator-associated pneumonia recurrences obtained by the Delphi method: the RECUVAP study.Intensive care medicine · 2025Article
- Difficult-to-TreatAntibiotics (Basel, Switzerland) · 2025Review
- The use of extracorporeal membrane oxygenation in COVID-19: a systematic review.Archives of medical science : AMS · 2025Review
- The COVID-19 pandemic: an underlying factor for increasedFrontiers in microbiology · 2025Review
- Knowledge, attitude, and practice of nurses in ICU on preventing ventilator-associated pneumonia: a cross-sectional study in Gansu Province, China.Frontiers in medicine · 2025Article
- Similar Kinetics of Pulmonary SARS-CoV-2 Load in Intensive Care Unit Patients with COVID-19 Pneumonia with or Without Autoantibodies Neutralizing Type I Interferons.Journal of clinical immunology · 2024Article
- Microbial dynamics and pulmonary immune responses in COVID-19 secondary bacterial pneumonia.Nature communications · 2024Article
- Improving Outcomes in Nosocomial Pneumonia: Recent Evidence and More Challenges.Pathogens (Basel, Switzerland) · 2024Review
- Recurrent ventilator-associated pneumonia in severe Covid-19 ARDS patients requiring ECMO support.Annals of intensive care · 2024Article
- Multidrug-resistant pathogens and ventilator-associated pneumonia in critically ill COVID-19 and non-COVID-19 patients: a prospective observational monocentric comparative study.Respiratory research · 2024Article
- Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study.Critical care (London, England) · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe data on incidence, clinical presentation, and outcomes of ventilator-associated pneumonia (VAP) in patients with severe coronavirus disease 2019 (COVID-19) pneumonia requiring mechanical ventilation (MV) are limited. We performed this retrospective cohort study to assess frequency, clinical characteristics, responsible pathogens, and outcomes of VAP in patients COVID-19 pneumonia requiring MV between March 12th and April 24th, 2020 (all had RT-PCR-confirmed SARS-CoV-2 infection). Patients with COVID-19-associated acute respiratory distress syndrome (ARDS) requiring ECMO were compared with an historical cohort of 45 patients with severe influenza-associated ARDS requiring ECMO admitted to the same ICU during the preceding three winter seasons.
resultsAmong 50 consecutive patients with Covid-19-associated ARDS requiring ECMO included [median (IQR) age 48 (42-56) years; 72% male], 43 (86%) developed VAP [median (IQR) MV duration before the first episode, 10 (8-16) days]. VAP-causative pathogens were predominantly Enterobacteriaceae (70%), particularly inducible AmpC-cephalosporinase producers (40%), followed by Pseudomonas aeruginosa (37%). VAP recurred in 34 (79%) patients and 17 (34%) died. Most recurrences were relapses (i.e., infection with the same pathogen), with a high percentage occurring on adequate antimicrobial treatment. Estimated cumulative incidence of VAP, taking into account death and extubation as competing events, was significantly higher in Covid-19 patients than in influenza patients (p = 0.002). Despite a high P. aeruginosa-VAP rate in patients with influenza-associated ARDS (54%), the pulmonary infection recurrence rate was significantly lower than in Covid-19 patients. Overall mortality was similar for the two groups.
conclusionsPatients with severe Covid-19-associated ARDS requiring ECMO had a very high late-onset VAP rate. Inducible AmpC-cephalosporinase-producing Enterobacteriaceae and Pseudomonas aeruginosa frequently caused VAP, with multiple recurrences and difficulties eradicating the pathogen from the lung.
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