ReviewAnnals of intensive care2024
Microbiological features of drowning-associated pneumonia: a systematic review and meta-analysis.
Review in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Respiratory Emergencies in Disasters: A Narrative Review.Thoracic research and practice · 2026Article
- Pulmonary Infiltrates, Airway Mucosal Lesions and Respiratory Microbiology After Freshwater Drowning: A Case Report.Respirology case reports · 2026Article
- Rescue strategies combining ultra-protective ventilation and veno-venous ECMO in a patient with near-drowning-related severe ARDS: a case report and literature review.BMC anesthesiology · 2026Review
- Managing Pneumonia Due to Rare Non-Fermenting Gram-Negative Bacteria: Epidemiology, Risk Factors and Therapeutic Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Microbial characteristics and risk factors in PICU with freshwater drowning-associated pneumonia.European journal of pediatrics · 2026Article
- Diagnostic Challenge and Treatment Delay in Drowning-Associated Pneumonia: A Case of CombinedCase reports in infectious diseases · 2026Article
- Seawater drowning induced acute lung injury: new insights from novel mouse models and micro-CT imaging.Open medicine (Warsaw, Poland) · 2026Article
- Genomic characterization of non-O1, non-O139 Vibrio cholerae causing rare clinical manifestation.BMC infectious diseases · 2025Article
- Washing machine-induced trauma and coagulopathy in a kitten.The Canadian veterinary journal = La revue veterinaire canadienne · 2024Article
- Fulminant fatal pneumonia and bacteremia due toFrontiers in cellular and infection microbiology · 2024Review
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrowning-associated pneumonia (DAP) is frequent in drowned patients, and possibly increases mortality. A better understanding of the microorganisms causing DAP could improve the adequacy of empirical antimicrobial therapy. We aimed to describe the pooled prevalence of DAP, the microorganisms involved, and the impact of DAP on drowned patients.
methodsSystematic review and meta-analysis of studies published between 01/2000 and 07/2023 reporting on DAP occurrence and microorganisms involved.
resultsOf 309 unique articles screened, 6 were included, involving 688 patients. All were retrospective cohort studies, with a number of patients ranging from 37 to 270. Studies were conducted in Europe (France N = 3 and Netherland N = 1), United States of America (N = 1) and French West Indies (N = 1). Mortality ranged between 18 to 81%. The pooled prevalence of DAP was 39% (95%CI 29-48), similarly following freshwater (pooled prevalence 44%, 95%CI 36-52) or seawater drowning (pooled prevalence 42%, 95%CI 32-53). DAP did not significantly impact mortality (pooled odds ratio 1.43, 95%CI 0.56-3.67) but this estimation was based on two studies only. Respiratory samplings isolated 171 microorganisms, mostly Gram negative (98/171, 57%) and mainly Aeromonas sp. (20/171, 12%). Gram positive microorganisms represented 38/171 (22%) isolates, mainly Staphylococcus aureus (21/171, 12%). Water salinity levels had a limited impact on the distribution of microorganisms, except for Aeromonas sp. who were exclusively found following freshwater drowning (19/106, 18%) and never following seawater drowning (0%) (p = 0.001). No studies reported multidrug-resistant organisms but nearly 30% of the isolated microorganisms were resistant to amoxicillin-clavulanate, the drug that was the most commonly prescribed empirically for DAP.
conclusionsDAP are commonly caused by Gram-negative bacteria, especially Aeromonas sp. which is exclusively isolated following freshwater drowning. Empirical antimicrobial therapy should consider covering them, noting than amoxicillin-clavulanate may be inadequate in about one-third of the cases. The impact of DAP on patients' outcome is still unclear.
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