OBJECTIVES: 

Little is known about the epidemiology of ventilator-acquired pneumonia among coronavirus disease 2019 patients such as incidence or etiological agents. Some studies suggest a higher risk of ventilator-associated pneumonia in this specific population.

DESIGN: 

Cohort exposed/nonexposed study among the REA-REZO surveillance network.

SETTING: 

Multicentric; ICUs in France.

PATIENTS: 

The coronavirus disease 2019 patients at admission were matched on the age, sex, center of inclusion, presence of antimicrobial therapy at admission, patient provenance, time from ICU admission to mechanical ventilation, and Simplified Acute Physiology Score II at admission to the patients included between 2016 and 2019 within the same surveillance network (1:1).

INTERVENTIONS: 

None.

MEASUREMENTS AND MAIN RESULTS: 

The overall incidence of ventilator-associated pneumonia, the cumulative incidence, and hazard rate of the first and the second ventilator-associated pneumonia were estimated. In addition, the ventilator-associated pneumonia microbiological ecology and specific resistant pattern in coronavirus disease 2019 exposed and nonexposed patients were compared. Medication data were not collected. A total of 1,879 patients were included in each group. The overall incidence of ventilator-associated pneumonia was higher among coronavirus disease 2019 exposed patients (25.5; 95% CI [23.7–27.45] vs 15.4; 95% CI [13.7–17.3] ventilator-associated pneumonia per 1,000 ventilation days). The cumulative incidence was higher for the first and the second ventilator-associated pneumonia among the coronavirus disease 2019 exposed patients (respective Gray test p < 0.0001 and 0.0167). The microbiological ecology and resistance were comparable between groups with a predominance of Enterobacterales and nonfermenting Gram-negative bacteria. The documented resistance pattern was similar between groups, except for a lower rate of methicillin-resistant Staphylococcus aureus in the coronavirus disease 2019 exposed patient (6% vs 23%; p = 0.013).

CONCLUSIONS: 

There was a higher incidence of ventilator-associated pneumonia occurring among coronavirus disease 2019 patient compared with the general ICU population, with a similar microbiological ecology and resistance pattern.

中文翻译：

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2019 年冠状病毒病患者呼吸机获得性肺炎的发病率增加：一项多中心队列研究*

目标： 

关于 2019 冠状病毒病患者呼吸机获得性肺炎的流行病学，如发病率或病原体，知之甚少。一些研究表明，这一特定人群患呼吸机相关性肺炎的风险更高。

设计： 

REA-REZO 监测网络中的队列暴露/非暴露研究。

环境： 

多中心；法国的 ICU。

患者： 

入院时的 2019 年冠状病毒病患者在年龄、性别、纳入中心、入院时是否接受抗菌治疗、患者出处、从 ICU 入院到机械通气的时间以及入院时的简化急性生理学评分 II 之间匹配2016 年和 2019 年在同一监控网络内 (1:1)。

干预措施： 

没有任何。

测量和主要结果： 

估计呼吸机相关性肺炎的总体发生率、累计发生率以及第一次和第二次呼吸机相关性肺炎的危险率。此外，比较了 2019 冠状病毒病暴露和未暴露患者的呼吸机相关肺炎微生物生态学和特异性耐药模式。未收集用药数据。每组共包括 1,879 名患者。2019 冠状病毒病暴露患者呼吸机相关性肺炎的总体发生率较高（25.5；95% CI [23.7–27.45] vs 15.4；95% CI [13.7–17.3]呼吸机相关性肺炎每 1,000 个通风日）。在 2019 冠状病毒病暴露患者中，第一次和第二次呼吸机相关肺炎的累积发病率更高（各自的灰色检验p < 0.0001 和 0.0167）。肠杆菌和非发酵革兰氏阴性菌占优势的组之间的微生物生态学和耐药性具有可比性。记录的耐药模式在各组之间相似，除了2019 年冠状病毒病暴露患者的耐甲氧西林金黄色葡萄球菌发生率较低（6% 对 23%； p = 0.013）。

结论： 

与普通 ICU 人群相比，2019 冠状病毒病患者呼吸机相关肺炎的发生率更高，具有相似的微生物生态学和耐药模式。