Staphylococcus aureus colonization at ICU admission as a risk factor for developing S. aureus ICU pneumonia

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• 作者：F.P. Paling¹ ; ^{f.p.paling@umcutrecht.nl} ; M. Wolkewitz² ; L.G.M. Bode³ ; P.M.C. Klein Klouwenberg³ ; ⁴ ; D.S.Y. Ong³ ; ⁴ ; P. Depuydt⁵ ; L. de Bus⁵ ; F. Sifakis⁶ ; M.J.M. Bonten¹ ; ³ ; J.A.J.W. Kluytmans¹
• 关键词：Colonization ; Intensive care ; Pneumonia ; S. aureus ; VAP
• 刊名：Clinical Microbiology and Infection
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：23
• 期：1
• 页码：49.e9-49.e14
• 全文大小：607 K
• 卷排序：23

文摘

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.MethodsThis 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.ResultsThe 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.ConclusionThe 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.