Table 1.
Characteristics of 120 study patients diagnosed with SA-VAP
| Total (n = 120) | COVID-19 (n = 40) | Non–COVID-19 (n = 80) | P value | |
|---|---|---|---|---|
| Demographics | ||||
| Age, years | 63 [52–70] | 64 [58–70] | 62 [47–74] | 0.21 |
| Male, N (%) | 92 (76.7) | 33 (82.5) | 59 (73.8) | 0.36 |
| SAPS II score | 38 [30–43] | 38 [32.5–46.5] | 38 [29–40.5] | 0.15 |
| Comorbidities | ||||
| Cardiovascular disease, N (%) | 20 (16.7) | 7 (17.5) | 13 (16.3) | 0.8 |
| Diabetes, N (%) | 19 (15.8) | 8 (20.0) | 11 (13.8) | 0.43 |
| COPD, N (%) | 19 (15.8) | 7 (17.5) | 12 (15.0) | 0.79 |
| Chronic renal failure, N (%) | 11 (9.2) | 3 (7.5) | 8 (10.0) | 0.75 |
| Immunosuppression, N (%) | 8 (6.7) | 4 (10.0) | 4 (5.0) | 0.44 |
| Neoplasm, N (%) | 7 (5.8) | 4 (10.0) | 3 (3.8) | 0.22 |
| Characteristics at diagnosis | ||||
| Respiratory failure, N (%)a | 112 (93.3) | 40 (100) | 72 (90%) | 0.1 |
| Length of stay in ICU, days | 8 [7–12] | 11.5 [4–19] | 8 [7–9] | 0.29 |
| Duration of mechanical ventilation, days | 6 [5–10] | 9 [4–17] | 6 [5–7] | 0.14 |
| SOFA scoreb | 7 [5–9] | 7 [4–9] | 7 [5–9] | 0.51 |
| Previous antibiotics, N (%)c | 67 (55.8) | 25 (62.5) | 42 (52.5) | 0.39 |
| Characteristics after diagnosis | ||||
| Length of stay in ICU, days | 12 [6.5–23.5] | 11 [6–22] | 14 [6.5–24] | 0.46 |
| Duration of mechanical ventilation, days | 7 [3–11] | 7 [2.5–11] | 6.5 [3–11] | 0.86 |
| SA-VAP features | ||||
| Late-onset infection, N (%) | 86 (71.7) | 35 (87.5) | 51 (63.8) | 0.01 |
| Methicillin-resistant infection, N (%) | 48 (40.0) | 26 (65.0) | 22 (27.5) | < 0.01 |
| Bacteraemic infection, N (%) | 24 (20.0) | 19 (47.5) | 5 (6.3) | < 0.01 |
| Complicationsb | ||||
| Septic shock, N (%) | 65 (54.2) | 22 (55.0) | 43 (53.8) | 1 |
| Acute kidney injury requiring CRRT, N (%) | 12 (10.0) | 4 (10.0) | 8 (10.0) | 1 |
| Antistaphylococcal antimicrobial therapy | ||||
| Oxacillin, N (%) | 31 (25.8) | 9 (22.5) | 22 (27.5) | 0.66 |
| Vancomycin, N (%) | 21 (17.5) | 5 (12.5) | 16 (20.0) | 0.45 |
| Linezolid, N (%) | 32 (26.7) | 24 (60.0) | 8 (10.0) | < 0.01 |
| Other antimicrobials, N (%)d | 36 (30.0) | 2 (5.0) | 34 (42.5) | < 0.01 |
| Initial inadequate antimicrobial therapy, N (%) | 32 (26.7) | 13 (32.5) | 19 (23.8) | 0.38 |
| Duration of antimicrobial therapy, days | 8 [6–10] | 9.5 [7–10] | 7 [5–10.5] | 0.12 |
| Vancomycin MIC < 1 mcg/mL, N (%) | 61 (50.8) | 22 (55.0) | 39 (48.8) | 1 |
| Linezolid MIC < 2 mcg/mL, N (%) | 29 (24.2) | 11 (27.5) | 18 (22.5) | 0.51 |
| Outcomes | ||||
| Clinical cure, N (%) | 90 (75.0) | 27 (67.5) | 63 (78.9) | 0.2 |
| Microbiological cure, N (%)e | 42 (50.6) | 16 (43.2) | 26 (56.5) | 0.31 |
| ICU death, N (%) | 30 (25.0) | 14 (35.0) | 16 (20.0) | 0.12 |
| In-hospital death, N (%) | 32 (26.7) | 14 (35.0) | 18 (22.5) | 0.19 |
Data are presented as median [IQR], unless otherwise indicated
Significant values are in bold (P values < 0.1)
SA Staphylococcus aureus, VAP ventilator-associated pneumonia, SAPS II Simplified Acute Physiology Score, COPD chronic obstructive pulmonary disease, ICU Intensive Care Unit, SOFA Sequential Organ Failure Assessment, CRRT continuous renal replacement therapy, MIC minimal inhibitory concentration; IQR interquartile range
a72 out of 80 controls were admitted to ICU with respiratory failure due to different origins (community-acquired/nosocomial pneumonia, chest trauma, ARDS due to septic shock, COPD exacerbations, coma with suspicion of inhalation). Remaining 8 patients were admitted due post-surgical haemorragic shock (n = 3) and major trauma (n = 5)
bThe day of VAP diagnosis
cAntibiotics received ≥ 48 h during previous 30 days: amoxicillin/clavulanic acid, piperacillina/tazobactam, ceftolozane/tazobactam, ceftriaxone, cefepime, meropenem, amikacin, vancomycin, linezolid, colistin, tigecycline, azytromicin, levofloxacin
dAmoxicillin clavulanic-acid (n = 19), quinolones (n = 15), trimethoprim sulphametoxazole (n = 2)
eMicrobiological eradication was evaluated in 83 pts (37 COVID-19+ and 46 controls)