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Clinical and microbiological features of drowning-associated pneumonia: a retrospective multicentre cohort study

Florian Reizine1, Agathe Delbove2, Pierre Tattevin1

  • 1CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|August 9, 2022
PubMed
Abstract

Insights

Pneumonia is a frequent complication following drowning incidents, significantly increasing intensive care unit (ICU) patient mortality. Early identification and management of drowning-associated pneumonia (DAP) are crucial for improving patient outcomes.

Area of Science:

  • Intensive Care Medicine
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Pneumonia is the most common infectious complication in drowning victims requiring intensive care.
  • Understanding the clinical, microbiological, and therapeutic aspects of pneumonia post-drowning is essential.

Purpose of the Study:

  • To describe the clinical and microbiological features of pneumonia in drowning patients.
  • To identify predictors and assess the impact of drowning-associated pneumonia (DAP) on patient outcomes.
  • To analyze empirical antibacterial treatment strategies.

Main Methods:

  • Retrospective, multicenter study involving 270 drowning patients across 14 ICUs in Western France (2013-2020).
  • Pneumonia defined as diagnosed within 48 hours of ICU admission.
  • Cox and logistic regression models used to analyze survival and risk factors for DAP.

Main Results:

  • Pneumonia occurred in 37.4% of drowning patients; microbiologically proven DAP in 12.2%.
  • Pneumonia associated with higher severity scores and longer ICU stays.
  • 28-day mortality was significantly higher in patients with pneumonia (28.7% vs. 15.4%).
  • Microbiologically proven DAP independently associated with increased 28-day mortality (aHR, 1.86).
  • High prevalence of Gram-negative bacilli and amoxicillin-clavulanate resistance observed.

Conclusions:

  • Pneumonia is a common and serious complication in ICU patients following drowning.
  • Drowning-associated pneumonia significantly increases patient mortality.
  • Further research into optimal antibiotic strategies for DAP is warranted.
Keywords:
Antimicrobial strategyCritical careDrowningMicroorganismsPneumonia

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