@article{ref1,
title="Clinical and microbiological features of drowning-associated pneumonia: a retrospective multicenter cohort study",
journal="Clinical Microbiology and Infection : The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases",
year="2022",
author="Reizine, Florian and Delbove, Agathe and Tattevin, Pierre and Santos, Alexandre Dos and Bodenes, Laetitia and Bouju, Pierre and Fillatre, Pierre and Frérou, Aurélien and Halley, Guillaume and Lesieur, Olivier and Courouble, Patricia and Berteau, Florian and Morin, Jean and Delamaire, Flora and Marnai, Rémy and Le Meur, Anthony and Aubron, Cécile and Reignier, Jean and Gacouin, Arnaud and Tadié, Jean-Marc",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: Pneumonia is the most frequent infectious complication among drowning patients requiring intensive care unit (ICU) admission. We aimed to describe clinical, microbiological and therapeutic data as well as predictors and impacts on patients 'outcomes of such pneumonia. <br><br>METHODS: We conducted a retrospective multicenter study (2013-2020) of 270 consecutive patients admitted for drowning to 14 ICUs in the west of France. Baseline characteristics and outcomes were compared according to the occurrence of drowning associated pneumonia (DAP), defined as pneumonia diagnosed within 48 hours of ICU admission. A Cox model was performed to compare survival at day-28 and logistic regression to identify risk factors for DAP. Microbiological characteristics and empirical antibacterial treatment were also analyzed. <br><br>RESULTS: Among the 270 patients admitted to the ICU for drowning, 101/270 (37.4%) and 33/270 (12.2%) experienced pneumonia and microbiologically proven DAP, respectively. The occurrence of pneumonia was associated with higher severity scores at ICU admission (Median SAPS 2 score 34 ​​[Interquartile range 25-55] versus 45 ​​[28-67]; P=0.006) and longer ICU length of stay (2 days ​​[1-3] versus 4 ​​[2-7]; P<0.001). Mortality at day-28 was higher among these patients (29/101 (28.7%) versus 26/169 (15.4%); P=0.013). Microbiologically proven DAP remained associated with higher day-28 mortality after adjustments for cardiac arrest and water salinity (adjusted HR 1.86 [95%CI 1.06-3.28]; P=0.03). Microbiological analysis of respiratory samples showed a high proportion of gram-negative bacilli (23/56; 41.1%) with high prevalence of amoxicillin-clavulanate resistance (12/33; 36.4%). <br><br>CONCLUSION: Pneumonia is a common complication in patients admitted in ICU for drowning, associated with increased mortality.<p /> <p>Language: en</p>",
language="en",
issn="1198-743X",
doi="10.1016/j.cmi.2022.07.027",
url="http://dx.doi.org/10.1016/j.cmi.2022.07.027"
}