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dc.contributor.authorMaes, Mailis
dc.contributor.authorHigginson, Ellen
dc.contributor.authorPereira-Dias, Joana
dc.contributor.authorCurran, Martin D.
dc.contributor.authorParmar, Surendra
dc.contributor.authorKhokhar, Fahad
dc.contributor.authorCuchet-Lourenço, Delphine
dc.contributor.authorLux, Janine
dc.contributor.authorSharma-Hajela, Sapna
dc.contributor.authorRavenhill, Benjamin
dc.contributor.authorHamed, Islam
dc.contributor.authorHeales, Laura
dc.contributor.authorMahroof, Razeen
dc.contributor.authorSoderholm, Amelia
dc.contributor.authorForrest, Sally
dc.contributor.authorSridhar, Sushmita
dc.contributor.authorBrown, Nicholas M.
dc.contributor.authorBaker, Stephen
dc.contributor.authorNavapurkar, Vilas
dc.contributor.authorDougan, Gordon
dc.contributor.authorBartholdson Scott, Josefin
dc.contributor.authorConway Morris, Andrew
dc.date.accessioned2021-04-07T15:41:54Z
dc.date.available2021-04-07T15:41:54Z
dc.date.issued2021-01-11
dc.date.submitted2020-10-07
dc.identifier.others13054-021-03460-5
dc.identifier.other3460
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/319523
dc.description.abstractAbstract: Background: Pandemic COVID-19 caused by the coronavirus SARS-CoV-2 has a high incidence of patients with severe acute respiratory syndrome (SARS). Many of these patients require admission to an intensive care unit (ICU) for invasive ventilation and are at significant risk of developing a secondary, ventilator-associated pneumonia (VAP). Objectives: To study the incidence of VAP and bacterial lung microbiome composition of ventilated COVID-19 and non-COVID-19 patients. Methods: In this retrospective observational study, we compared the incidence of VAP and secondary infections using a combination of microbial culture and a TaqMan multi-pathogen array. In addition, we determined the lung microbiome composition using 16S RNA analysis in a subset of samples. The study involved 81 COVID-19 and 144 non-COVID-19 patients receiving invasive ventilation in a single University teaching hospital between March 15th 2020 and August 30th 2020. Results: COVID-19 patients were significantly more likely to develop VAP than patients without COVID (Cox proportional hazard ratio 2.01 95% CI 1.14–3.54, p = 0.0015) with an incidence density of 28/1000 ventilator days versus 13/1000 for patients without COVID (p = 0.009). Although the distribution of organisms causing VAP was similar between the two groups, and the pulmonary microbiome was similar, we identified 3 cases of invasive aspergillosis amongst the patients with COVID-19 but none in the non-COVID-19 cohort. Herpesvirade activation was also numerically more frequent amongst patients with COVID-19. Conclusion: COVID-19 is associated with an increased risk of VAP, which is not fully explained by the prolonged duration of ventilation. The pulmonary dysbiosis caused by COVID-19, and the causative organisms of secondary pneumonia observed are similar to that seen in critically ill patients ventilated for other reasons.
dc.languageen
dc.publisherBioMed Central
dc.subjectResearch
dc.subjectCOVID-19
dc.subjectSARS-CoV-2
dc.subjectNosocomial infections
dc.subjectMolecular diagnostics
dc.subjectVentilator-associated pneumonia
dc.subjectCritical care
dc.titleVentilator-associated pneumonia in critically ill patients with COVID-19
dc.typeArticle
dc.date.updated2021-04-07T15:41:53Z
prism.issueIdentifier1
prism.publicationNameCritical Care
prism.volume25
dc.identifier.doi10.17863/CAM.66644
dcterms.dateAccepted2021-01-04
rioxxterms.versionofrecord10.1186/s13054-021-03460-5
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidConway Morris, Andrew [0000-0002-3211-3216]
dc.identifier.eissn1364-8535
pubs.funder-project-idWellcome Trust (WT 2055214/Z/16/Z)
pubs.funder-project-idNational Institute for Health Research (Cambridge BRC grant)


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