Prevalence of Bacterial Codetection and Outcomes for Infants Intubated for Respiratory Infections.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
26 Mar 2024
26 Mar 2024
Historique:
medline:
26
3
2024
pubmed:
26
3
2024
entrez:
26
3
2024
Statut:
aheadofprint
Résumé
To determine the prevalence of respiratory bacterial codetection in children younger than 2 years intubated for acute lower respiratory tract infection (LRTI), primarily viral bronchiolitis, and identify the association of codetection with mechanical ventilation duration. Prospective observational study evaluating the prevalence of bacterial codetection (moderate/heavy growth of pathogenic bacterial plus moderate/many polymorphonuclear neutrophils) and the impact of codetection on invasive mechanical ventilation (IMV) duration. PICUs in 12 high and low/middle-income countries. Children younger than 2 years old requiring intubation and ICU admission for LRTI and who had a lower respiratory tract culture obtained at the time of intubation between December 1, 2019, and November 30, 2020. None. Of the 472 analyzed patients (median age 4.5 mo), 55% had a positive respiratory culture and 29% (n = 138) had codetection. 90% received early antibiotics starting at a median of 0.36 hours after respiratory culture. Median (interquartile range) IMV duration was 151 hours (88, 226), and there were 28 deaths (5.3%). Codetection was more common with younger age, a positive respiratory syncytial virus test, and an admission diagnosis of bronchiolitis; it was less common with an admission diagnosis of pneumonia, with admission to a low-/middle-income site, and in those receiving vasopressors. When adjusted for confounders, codetection was not associated with longer IMV duration (adjusted relative risk 0.854 [95% CI 0.684-1.065]). We could not exclude the possibility that codetection might be associated with a 30-hour shorter IMV duration compared with no codetection, although the CI includes the null value. Bacterial codetection was present in almost a third of children younger than 2 years requiring intubation and ICU admission for LRTI, but this was not associated with prolonged IMV. Further large studies are needed to evaluate if codetection is associated with shorter IMV duration.
Identifiants
pubmed: 38530103
doi: 10.1097/PCC.0000000000003500
pii: 00130478-990000000-00327
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Adriana Yock-Corrales
(A)
Alex Rotta
(A)
Andrew Prout
(A)
Andrew Wen
(A)
Anna Camporesi
(A)
Arieth Figueroa Vargas
(AF)
Bria Coates
(B)
Byron Enrique Piñeres-Olave
(BE)
Casey Stulce
(C)
Christopher Watson
(C)
Conall Francoeur
(C)
Edwin Mauricio Cantillano
(EM)
Eliana Zemanete
(E)
Francisca Castro
(F)
Gema Perez Yague
(GP)
Goktug Ozdemir
(G)
Harsha Chandnani
(H)
Ilana Harwayne-Gidansky
(I)
Karina Cinquegrani
(K)
Ledys Izquierdo
(L)
Lee Polikoff
(L)
Leonardo Valero
(L)
Mary Gaspers
(M)
Mia Maamari
(M)
Murat Kangin
(M)
Nils Casson Rodriguez
(NC)
Nilufer Ozturk
(N)
Pablo Castellani
(P)
Paras Khandhar
(P)
Roberto Jabornisky
(R)
Rosa Arana
(R)
Rosalba Pardo
(R)
Rubén Lasso Palomino
(RL)
Ryan Nofziger
(R)
Santiago Ayala Torales
(SA)
Shashikanth Ambati
(S)
Shira Gertz
(S)
Simi Jeyapalan
(S)
Srinivas Murthy
(S)
Teddy Muisyo
(T)
Weerapong Lillitwat
(W)
Yurika Lopez-Alarcon
(Y)
Informations de copyright
Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
Dr. Shein received funding from Ceribell. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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