F P Paling1, M Wolkewitz2, L G M Bode3, P M C Klein Klouwenberg4, D S Y Ong4, P Depuydt5, L de Bus5, F Sifakis6, M J M Bonten7, J A J W Kluytmans8. 1. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: f.p.paling@umcutrecht.nl. 2. Institute for Medical Biometry and Statistics, University Medical Center Freiburg, Freiburg, Germany. 3. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands. 4. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands; Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, Netherlands. 5. Department of Intensive Care Medicine, University Hospital of Ghent, Ghent, Belgium. 6. AstraZeneca LP, Gaithersburg, MD, USA. 7. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands. 8. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
Abstract
OBJECTIVE: To quantify the incidence of intensive care unit (ICU)-acquired pneumonia caused by Staphylococcus aureus (S. aureus) and its association with S. aureus colonization at ICU admission. METHODS: This was a post-hoc analysis of two cohort studies in critically ill patients. The primary outcome was the incidence of microbiologically confirmed S. aureus ICU-acquired pneumonia. Incidences of S. aureus ICU pneumonia and associations with S. aureus colonization at ICU admission were determined using competing risks analyses. In all ICUs, patients were screened for respiratory tract S. aureus carriage on admission as part of infection control policies. Pooling of data was not deemed possible because of heterogeneity in baseline differences in patient population. RESULTS: The two cohort studies contained data of 9156 ICU patients. The average carriage rate of S. aureus among screened patients was 12.7%. In total, 1185 (12.9%) patients developed ICU pneumonia. Incidences of S. aureus ICU pneumonia were 1.33% and 1.08% in cohorts 1 and 2, respectively. After accounting for competing events, the adjusted subdistribution hazard ratio (SHR) of S. aureus colonization at admission for developing S. aureus ICU pneumonia was 9.55 (95% CI 5.31-17.18) in cohort 1 and 14.54 (95% CI 7.24-29.21) in cohort 2. CONCLUSION: The overall cumulative incidence of S. aureus ICU pneumonia in these ICUs was low. Patients colonized with S. aureus at ICU admission had an up to 15 times increased risk for developing this outcome compared with non-colonized patients.
OBJECTIVE: To quantify the incidence of intensive care unit (ICU)-acquired pneumonia caused by Staphylococcus aureus (S. aureus) and its association with S. aureus colonization at ICU admission. METHODS: This was a post-hoc analysis of two cohort studies in critically illpatients. The primary outcome was the incidence of microbiologically confirmed S. aureus ICU-acquired pneumonia. Incidences of S. aureus ICU pneumonia and associations with S. aureus colonization at ICU admission were determined using competing risks analyses. In all ICUs, patients were screened for respiratory tract S. aureus carriage on admission as part of infection control policies. Pooling of data was not deemed possible because of heterogeneity in baseline differences in patient population. RESULTS: The two cohort studies contained data of 9156 ICU patients. The average carriage rate of S. aureus among screened patients was 12.7%. In total, 1185 (12.9%) patients developed ICU pneumonia. Incidences of S. aureus ICU pneumonia were 1.33% and 1.08% in cohorts 1 and 2, respectively. After accounting for competing events, the adjusted subdistribution hazard ratio (SHR) of S. aureus colonization at admission for developing S. aureus ICU pneumonia was 9.55 (95% CI 5.31-17.18) in cohort 1 and 14.54 (95% CI 7.24-29.21) in cohort 2. CONCLUSION: The overall cumulative incidence of S. aureus ICU pneumonia in these ICUs was low. Patients colonized with S. aureus at ICU admission had an up to 15 times increased risk for developing this outcome compared with non-colonized patients.
Authors: Alexey Ruzin; Olivier Barraud; Li Yu; Bruno François; Miguel Sánchez-Garcia; Philippe Eggimann; Pierre-François Dequin; Pierre-François Laterre; Vincent Huberlant; Lucia Viña; Thierry Boulain; Cedric Bretonniere; Jérôme Pugin; José Trenado; Ana Catalina Hernandez Padilla; Julie Vignaud; Drieke Vandamme; Herman Goossens; Christine Lammens; S Omar Ali; Kathryn Shoemaker; Pin Ren; Susan Colbert; Terramika Bellamy; Bret R Sellman; Michael McCarthy; Hasan S Jafri; Mark T Esser Journal: J Clin Microbiol Date: 2022-06-27 Impact factor: 11.677
Authors: Fleur P Paling; Martin Wolkewitz; Pieter Depuydt; Liesbet de Bus; Frangiscos Sifakis; Marc J M Bonten; Jan A J W Kluytmans Journal: Antimicrob Resist Infect Control Date: 2017-04-20 Impact factor: 4.887
Authors: Fleur P Paling; Darren P R Troeman; Martin Wolkewitz; Rubana Kalyani; Daniël R Prins; Susanne Weber; Christine Lammens; Leen Timbermont; Herman Goossens; Surbhi Malhotra-Kumar; Frangiscos Sifakis; Marc J M Bonten; Jan A J W Kluytmans Journal: BMC Infect Dis Date: 2017-09-25 Impact factor: 3.090