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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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Influence of a Structured Microbiological Endotracheal Monitoring Program on the Outcome of Critically Ill COVID-19

Miriam Dibos1, Stefanie Julia Haschka1, Rami Abbassi1

  • 1Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.

Journal of Clinical Medicine
|September 9, 2023
PubMed
Abstract

Insights

A structured microbiological monitoring program did not increase mortality in COVID-19 patients with bacterial coinfection or ventilator-associated pneumonia (VAP). This approach aids in early detection and refined anti-infective therapy for better patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Bacterial superinfections significantly increase morbidity and mortality in viral pandemics like COVID-19.
  • Mechanical ventilation in COVID-19 patients poses a risk for secondary bacterial infections.

Purpose of the Study:

  • To evaluate the impact of a structured microbiological monitoring program on the outcomes of mechanically ventilated COVID-19 patients.
  • To assess the influence of bacterial coinfections and ventilator-associated pneumonia (VAP) on patient prognosis.

Main Methods:

  • A systematic microbiological monitoring program was implemented, involving endotracheal sample collection at intubation and every three days thereafter.
  • Analysis included bacterial pathogen spectrum, mortality rates, and durations of intensive care unit (ICU), hospital, and mechanical ventilation.

Main Results:

  • Bacterial coinfection was present in 29% of patients at intubation; 56% developed VAP within 48 hours.
  • Patients with VAP experienced longer ICU, hospital, and mechanical ventilation durations.
  • No significant difference in mortality was observed between patients with VAP and those without bacterial infection.

Conclusions:

  • Ventilator-associated pneumonia (VAP) is a frequent complication in COVID-19 patients requiring mechanical ventilation.
  • Implementing a structured microbiological monitoring program did not correlate with increased mortality in patients with bacterial coinfection or VAP.
  • Standardized microbiological screening can improve early detection of infections, optimize antimicrobial therapy, and positively impact patient outcomes.
Keywords:
COVID-19ICUSARS-CoV-2bacterial spectrumventilator-associated pneumonia

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