Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis
Authors' conclusion
ESBL-related VAP in COVID-19 critically-ill patients was not infrequent. Several risk factors were identified, among which some are modifiable and deserve further investigation. There was no impact of resistance of the first Enterobacterales related episode of VAP on outcome.
Study context
- Population
- Critically ill COVID-19 patients with Enterobacterales related ventilator associated pneumonia (VAP)of 4929 in COVID-ICU
- Participants
- 591 patients
- Exposure
- ESBL-E vs non ESBL-E related VAP
- ESBL-En = 115
- Outcome
- Risk factors and outcomes of ESBL-E related VAP
Methodological detailsmultivariable analysis
- Multivariable analysis
Main finding
As reported in the abstract
Incidence of ESBL-E related VAP and associated risk factors (multivariable)
ESBL-E
19%
115
Odds ratio (CI)P value
African origin (North Africa or Sub-Saharan Africa)
1.7(1.07–2.71)
P = 0.02Time between intubation and VAP
1.06(1.02–1.09)
P = 0.002PaO2/FiO2 ratio on the day of VAP
0.997(0.994–0.999)
P = 0.04Trimethoprim-sulfamethoxazole exposure
3.77(1.15–12.4)
P = 0.03Observational data: associations, not effects.
Further findings
CRE related VAP
- Patients developing CRE related VAP
- 8 (1%)
Weaning from MV and mortality
- Did not significantly differ between ESBL-E and non ESBL-E VAP
Original publication
Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis. Crit Care. Published 20 April 2024. doi:10.
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