COVID-19 与非 COVID-19 相关的院内肺炎:病因、发病率和死亡率有何不同?

IF 3.5 3区 医学 Q1 CRITICAL CARE MEDICINE Current Opinion in Critical Care Pub Date : 2024-10-01 Epub Date: 2024-07-10 DOI:10.1097/MCC.0000000000001192
Ignacio Martin-Loeches, Marcos I Restrepo
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引用次数: 0

摘要

综述目的:本综述探讨了与 2019 年冠状病毒病(COVID-19)相关和非 COVID 相关的院内肺炎,尤其是医院获得性肺炎(HAP)和呼吸机相关肺炎(VAP)之间的异同。报告对住院病人的病因、发病率和死亡率进行了严格评估,强调了严重急性呼吸系统综合征冠状病毒 2 大流行前后这些感染所造成的负担:最近的研究结果:最近的研究结果表明,在 COVID-19 大流行期间,医院内感染增加,机械通气患者中涉及严重细菌和真菌超级感染的病例显著增加。这些感染包括耐多药生物(MDRO)的高发病率,使治疗和康复变得更加复杂。值得注意的是,受延长机械通气时间和皮质类固醇等免疫抑制治疗的影响,COVID-19 患者的 VAP 感染率高于流感或其他呼吸道病毒感染者。这些并发症不仅延长了患者的住院时间,增加了医疗成本,还导致了更高的发病率和死亡率。了解这些模式对于制定有针对性的预防和治疗策略以管理和减轻常规或大流行病护理期间的医院内感染至关重要。
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COVID-19 vs. non-COVID-19 related nosocomial pneumonias: any differences in etiology, prevalence, and mortality?

Purpose of review: This review explores the similarities and differences between coronavirus disease 2019 (COVID-19)-related and non-COVID-related nosocomial pneumonia, particularly hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). It critically assesses the etiology, prevalence, and mortality among hospitalized patients, emphasizing the burden of these infections during the period before and after the severe acute respiratory syndrome coronavirus 2 pandemic.

Recent findings: Recent studies highlight an increase in nosocomial infections during the COVID-19 pandemic, with a significant rise in cases involving severe bacterial and fungal superinfections among mechanically ventilated patients. These infections include a higher incidence of multidrug-resistant organisms (MDROs), complicating treatment and recovery. Notably, COVID-19 patients have shown a higher prevalence of VAP than those with influenza or other respiratory viruses, influenced by extended mechanical ventilation and immunosuppressive treatments like corticosteroids.

Summary: The findings suggest that COVID-19 has exacerbated the frequency and severity of nosocomial infections, particularly VAP. These complications not only extend hospital stays and increase healthcare costs but also lead to higher morbidity and mortality rates. Understanding these patterns is crucial for developing targeted preventive and therapeutic strategies to manage and mitigate nosocomial infections during regular or pandemic care.

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来源期刊
Current Opinion in Critical Care
Current Opinion in Critical Care 医学-危重病医学
CiteScore
5.90
自引率
3.00%
发文量
172
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​​Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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