About: Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study

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About: Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study
Creator	Dubost, Clément Pottecher, Julien Bellut, Hugo Bouglé, Adrien Charpentier, Claire Gaudefroy, Julie Godet, Thomas Guerci, Philippe Hajage, David Kimmoun, Antoine Lalot, Jean-Marc Ledochowski, Stanislas Louis, Guillaume Mokhtari, Mokhtar Mongardon, Nicolas Novy, Emmanuel Tashk, Parvine
Source	PMC
abstract	BACKGROUND: There is little descriptive data on Stenotrophomonas maltophilia hospital-acquired pneumonia (HAP) in critically ill patients. The optimal modalities of antimicrobial therapy remain to be determined. Our objective was to describe the epidemiology and prognostic factors associated with S. maltophilia pneumonia, focusing on antimicrobial therapy. METHODS: This nationwide retrospective study included all patients admitted to 25 French mixed intensive care units between 2012 and 2017 with hospital-acquired S. maltophilia HAP during intensive care unit stay. Primary endpoint was time to in-hospital death. Secondary endpoints included microbiologic effectiveness and antimicrobial therapeutic modalities such as delay to appropriate antimicrobial treatment, mono versus combination therapy, and duration of antimicrobial therapy. RESULTS: Of the 282 patients included, 84% were intubated at S. maltophilia HAP diagnosis for duration of 11 [5–18] days. The Simplified Acute Physiology Score II was 47 [36–63], and the in-hospital mortality was 49.7%. Underlying chronic pulmonary comorbidities were present in 14.1% of cases. Empirical antimicrobial therapy was considered effective on S. maltophilia according to susceptibility patterns in only 30% of cases. Delay to appropriate antimicrobial treatment had, however, no significant impact on the primary endpoint. Survival analysis did not show any benefit from combination antimicrobial therapy (HR = 1.27, 95%CI [0.88; 1.83], p = 0.20) or prolonged antimicrobial therapy for more than 7 days (HR = 1.06, 95%CI [0.6; 1.86], p = 0.84). No differences were noted in in-hospital death irrespective of an appropriate and timely empiric antimicrobial therapy between mono- versus polymicrobial S. maltophilia HAP (p = 0.273). The duration of ventilation prior to S. maltophilia HAP diagnosis and ICU length of stay were shorter in patients with monomicrobial S. maltophilia HAP (p = 0.031 and p = 0.034 respectively). CONCLUSIONS: S. maltophilia HAP occurred in severe, long-stay intensive care patients who mainly required prolonged invasive ventilation. Empirical antimicrobial therapy was barely effective while antimicrobial treatment modalities had no significant impact on hospital survival. TRIAL REGISTRATION: clinicaltrials.gov, NCT03506191
has issue date	2019-11-21(xsd:dateTime)
bibo:doi	10.1186/s13054-019-2649-5
bibo:pmid	31752976
has license	cc-by
sha1sum (hex)	62fc5c5543e12e033fe0e16fd9ad499ddc44940e
schema:url	https://doi.org/10.1186/s13054-019-2649-5
resource representing a document's title	Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study
has PubMed Central identifier	PMC6873544
has PubMed identifier	31752976
schema:publication	Crit Care
resource representing a document's body	covid:62fc5c5543e12e033fe0e16fd9ad499ddc44940e#body_text
is schema:about of	named entity 'PROGNOSTIC FACTORS' named entity 'FOCUSING' named entity 'DETERMINED' covid:arg/62fc5c5543e12e033fe0e16fd9ad499ddc44940e named entity 'prognostic' named entity 'HAP' named entity 'epidemiology' named entity 'antimicrobial therapy' named entity 'S. maltophilia' named entity 'TMP-SMX' named entity 'data analysis' named entity 'SOFA score' named entity 'mortality rate' named entity 'septic shock' named entity 'medical charts' named entity 'S. maltophilia' named entity 'VAP' named entity 'resistant bacteria' named entity 'combination therapy' named entity 'virulence' named entity 'S. maltophilia' named entity 'R Foundation' named entity 'S. maltophilia' named entity 'pneumonia' named entity 'S. maltophilia' named entity 'ceftazidime/avibactam' named entity 'pneumonia' named entity 'ECMO' named entity 'chronic obstructive pulmonary disease' named entity 'antimicrobial therapy' named entity 'antimicrobial therapy' named entity 'combination therapy' named entity 'ICUs' named entity 'hypoxemia' named entity 'antimicrobial' named entity 'antimicrobial agents' named entity 'antimicrobial' named entity 'follow-up' named entity 'pneumonia' named entity 'S. maltophilia' named entity 'antibiotic therapy' named entity 'bacteremia' named entity 'clinicaltrials.gov' named entity 'S. maltophilia' named entity 'length of stay' named entity 'ICUs' named entity 'pneumonia' named entity 'S. maltophilia' named entity 'database' named entity 'SOFA score' named entity 'institutional review board' named entity 'ICU' named entity 'fluoroquinolones' named entity 'data analysis' named entity 'antibiotics' named entity 'antimicrobial' named entity '12,000' named entity 'standard deviation' named entity 'Vienna' named entity 'S. maltophilia' named entity 'primary endpoint' named entity 'CFU' named entity 'ticarcillin-clavulanate' named entity 'S. maltophilia' named entity 'S. maltophilia'

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