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Vascular fibrosis and extracellular matrix remodelling in post-COVID 19 conditions 后 COVID 19 条件下的血管纤维化和细胞外基质重塑
Infectious Medicine Pub Date : 2024-10-19 DOI: 10.1016/j.imj.2024.100147
Anna Kamdar , Robert Sykes , Cameron R. Thomson , Kenneth Mangion , Daniel Ang , Michelle AW Lee , Tom Van Agtmael , Colin Berry
{"title":"Vascular fibrosis and extracellular matrix remodelling in post-COVID 19 conditions","authors":"Anna Kamdar ,&nbsp;Robert Sykes ,&nbsp;Cameron R. Thomson ,&nbsp;Kenneth Mangion ,&nbsp;Daniel Ang ,&nbsp;Michelle AW Lee ,&nbsp;Tom Van Agtmael ,&nbsp;Colin Berry","doi":"10.1016/j.imj.2024.100147","DOIUrl":"10.1016/j.imj.2024.100147","url":null,"abstract":"<div><div>Causal associations between viral infections and acute myocardial injury are not fully understood, with mechanisms potentially involving direct cardiovascular involvement or systemic inflammation. This review explores plausible mechanisms of vascular fibrosis in patients with post-COVID-19 syndrome, focusing on extracellular matrix remodelling. Despite global attention, significant mechanistic or translational breakthroughs in the management of post-viral syndromes remain limited. No effective pharmacological or non-pharmacological interventions are currently available for patients experiencing persistent symptoms following COVID-19 infection. The substantial expansion of scientific knowledge resulting from collaborative efforts by medical experts, scientists, and government organisations in undertaking COVID-19 research could inform treatment strategies for other post-viral syndromes and respiratory illnesses. There is a critical need for clinical trials to evaluate potential therapeutic candidates, providing evidence to guide treatment decisions for post-COVID-19 syndromes.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protection conferred by booster vaccine doses in hospitalized patients with COVID-19 during the SARS-CoV-2 Omicron BA.2 and BA.5 epidemics from 2022 to 2023 in Greece 2022 至 2023 年 SARS-CoV-2 Omicron BA.2 和 BA.5 在希腊流行期间,COVID-19 强化疫苗剂量对住院患者的保护作用
Infectious Medicine Pub Date : 2024-10-18 DOI: 10.1016/j.imj.2024.100144
Helena C. Maltezou , Maria N. Gamaletsou , Maria Chini , Vasileios Petrakis , Vasiliki Rapti , Theodoros V. Giannouchos , Eleni Karantoni , Konstantinos Kounouklas , Panagiota Stamou , Αmalia Karapanou , Dimitrios Basoulis , Andrianna-Chrysovalanto Verykokkou , Kyriakos Souliotis , Periklis Panagopoulos , Dimitrios Hatzigeorgiou , Garyfalia Poulakou , Konstantinos N. Syrigos , Nikolaos V. Sipsas
{"title":"Protection conferred by booster vaccine doses in hospitalized patients with COVID-19 during the SARS-CoV-2 Omicron BA.2 and BA.5 epidemics from 2022 to 2023 in Greece","authors":"Helena C. Maltezou ,&nbsp;Maria N. Gamaletsou ,&nbsp;Maria Chini ,&nbsp;Vasileios Petrakis ,&nbsp;Vasiliki Rapti ,&nbsp;Theodoros V. Giannouchos ,&nbsp;Eleni Karantoni ,&nbsp;Konstantinos Kounouklas ,&nbsp;Panagiota Stamou ,&nbsp;Αmalia Karapanou ,&nbsp;Dimitrios Basoulis ,&nbsp;Andrianna-Chrysovalanto Verykokkou ,&nbsp;Kyriakos Souliotis ,&nbsp;Periklis Panagopoulos ,&nbsp;Dimitrios Hatzigeorgiou ,&nbsp;Garyfalia Poulakou ,&nbsp;Konstantinos N. Syrigos ,&nbsp;Nikolaos V. Sipsas","doi":"10.1016/j.imj.2024.100144","DOIUrl":"10.1016/j.imj.2024.100144","url":null,"abstract":"<div><h3>Background</h3><div>To estimate the protection that coronavirus disease 2019 (COVID-19) vaccine doses conferred to hospitalized patients with COVID-19 against adverse outcomes and longer length of stay during the Omicron BA.2 and BA.5 subvariant epidemics in Greece.</div></div><div><h3>Methods</h3><div>The study was conducted from November 2022 to May 2023. Multivariable logistic and negative binomial regression models were applied to estimate the association between any adverse outcomes and length of stay with the number of COVID-19 vaccine doses.</div></div><div><h3>Results</h3><div>We studied 962 patients (median age: 78 years; mean length of stay: 9.2 days), of whom 847 (88.0%) had ≥ 1 comorbidity. Of these, 39 (4.0%) were admitted to the intensive care unit, 44 (4.6%) received invasive mechanical ventilation, and 110 (11.4%) died in hospital. There were 184 (19.1%) unvaccinated patients, 125 (13.0%) with one or two vaccine doses, and 653 (67.9%) with ≥ 3 doses. In multivariable analyses, patients with ≥ 3 doses had lower odds of experiencing any adverse outcomes (adjusted odds ratio: 0.57; 95% confidence interval [CI]: 0.37–0.86) compared with unvaccinated patients. On average, patients with one or two doses and those with ≥ 3 had decreased length of hospital stay (−1.5 days [95% CIs: −2.6 to −0.4] and −2.8 days [95% CIs: −4.1 to −1.4], respectively] compared with unvaccinated patients. Other characteristics consistently associated with adverse outcomes and longer length of stay included older age, having three or more comorbidities compared with none, and being admitted to the hospital two or more weeks post-diagnosis.</div></div><div><h3>Conclusions</h3><div>A history of ≥ 3 vaccine doses conferred significant protection against any adverse outcome and longer length of stay in hospitalized patients with COVID-19.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic and prognostic value of disulfidptosis-related genes in sepsis 败血症中与二硫化硫相关基因的诊断和预后价值
Infectious Medicine Pub Date : 2024-10-17 DOI: 10.1016/j.imj.2024.100143
Wenlu Zou, Lintao Sai, Wen Sai, Li Song, Gang Wang
{"title":"Diagnostic and prognostic value of disulfidptosis-related genes in sepsis","authors":"Wenlu Zou,&nbsp;Lintao Sai,&nbsp;Wen Sai,&nbsp;Li Song,&nbsp;Gang Wang","doi":"10.1016/j.imj.2024.100143","DOIUrl":"10.1016/j.imj.2024.100143","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a disease associated with high morbidity and mortality rates, especially among the elderly and patients in intensive care units. Disulfidptosis, a newly identified form of cell death triggered by disulfide stress, is emerging as a significant factor in disease progression. This study aimed to explore the diagnostic and prognostic value of disulfidptosis-related genes in sepsis.</div></div><div><h3>Methods</h3><div>We obtained two datasets from the Gene Expression Omnibus (GEO) database to conduct our analysis. Functional enrichment analysis was performed to identify relevant biological pathways. A protein-protein interaction network was constructed to identify hub genes critical to sepsis. Additionally, we analyzed the immune infiltration status in sepsis patients. The diagnostic value of these hub genes for sepsis was evaluated using nomograms, receiver operating characteristic (ROC) curves, and calibration curves in both training and validation datasets. Finally, a miRNA-immune-related hub genes (miRNA-IHGs) regulatory network was developed to elucidate the synergistic interactions between miRNAs and their target genes.</div></div><div><h3>Results</h3><div>A total of 3,469 differentially expressed genes (DEGs) were identified, of which seven were related to disulfidptosis (DR-DEGs). Functional enrichment analysis showed that DR-DEGs were significantly enriched in pathways related to actin dynamics. Five hub genes (MYH10, ACTN4, MYH9, FLNA, and IQGAP1) were identified as central to these processes. The analysis of immune infiltration revealed significantly lower levels of 11 immune cell types, while macrophages and regulatory T cells were significantly elevated in sepsis patients. The area under the ROC curves (AUCs) of the IHGs risk prediction model were 0.917 and 0.894 for the training and validation sets, respectively. A miRNA-IHGs regulatory network, comprising 17 nodes and 27 edges, was constructed, with MYH9 being the most frequently regulated by miRNAs.</div></div><div><h3>Conclusion</h3><div>The pathophysiological process of sepsis appears to involve disulfidptosis, highlighting it as a potential new therapeutic targets for sepsis management.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple-site decontamination in critically ill patients requires careful implementation 重症患者的多部位净化需要谨慎实施
Infectious Medicine Pub Date : 2024-10-16 DOI: 10.1016/j.imj.2024.100142
Yuetian Yu , Bin Lin , Lihui Wang , Chunhui Xu , Cheng Zhu , Yuan Gao
{"title":"Multiple-site decontamination in critically ill patients requires careful implementation","authors":"Yuetian Yu ,&nbsp;Bin Lin ,&nbsp;Lihui Wang ,&nbsp;Chunhui Xu ,&nbsp;Cheng Zhu ,&nbsp;Yuan Gao","doi":"10.1016/j.imj.2024.100142","DOIUrl":"10.1016/j.imj.2024.100142","url":null,"abstract":"<div><div>The EPIC III study showed that 52% of patients admitted to the intensive care unit (ICU) have infectious diseases and that the incidence of ICU-acquired infections is increasing, leading to longer ICU stays and higher mortality rates. Multiple-site decontamination, a type of selective decontamination program, has been associated with a reduction in the incidence of ICU-acquired infection and decreased mortality rates in some critically ill patients. However, the standardized implementation and actual effectiveness of multiple-site decontamination require further investigation.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurorestorative therapeutic strategies for sequela of central nervous system infections 中枢神经系统感染后遗症的神经恢复治疗策略
Infectious Medicine Pub Date : 2024-10-11 DOI: 10.1016/j.imj.2024.100141
Hongyun Huang , Paul R. Sanberg , Hari Shanker Sharma
{"title":"Neurorestorative therapeutic strategies for sequela of central nervous system infections","authors":"Hongyun Huang ,&nbsp;Paul R. Sanberg ,&nbsp;Hari Shanker Sharma","doi":"10.1016/j.imj.2024.100141","DOIUrl":"10.1016/j.imj.2024.100141","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic challenges and eponyms in tuberculous arthritis 结核性关节炎的诊断难题和外来名称
Infectious Medicine Pub Date : 2024-09-26 DOI: 10.1016/j.imj.2024.100139
Jacob Draves , Halil Tekiner , Steven H. Yale , Eileen S. Yale
{"title":"Diagnostic challenges and eponyms in tuberculous arthritis","authors":"Jacob Draves ,&nbsp;Halil Tekiner ,&nbsp;Steven H. Yale ,&nbsp;Eileen S. Yale","doi":"10.1016/j.imj.2024.100139","DOIUrl":"10.1016/j.imj.2024.100139","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brain fog across the Mediterranean 横跨地中海的脑雾
Infectious Medicine Pub Date : 2024-09-26 DOI: 10.1016/j.imj.2024.100140
Souheil Zayet
{"title":"Brain fog across the Mediterranean","authors":"Souheil Zayet","doi":"10.1016/j.imj.2024.100140","DOIUrl":"10.1016/j.imj.2024.100140","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterization of isoniazid resistance and genetic mutations in isoniazid-resistant and rifampicin-susceptible Mycobacterium tuberculosis in China 中国耐异烟肼结核分枝杆菌和易感利福平结核分枝杆菌的异烟肼耐药性和基因突变特征
Infectious Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.imj.2024.100129
Dongxin Liu , Bing Zhao , Yang Zheng , Xichao Ou , Shengfen Wang , Yang Zhou , Yuanyuan Song , Hui Xia , Qiang Wei , YanLin Zhao
{"title":"Characterization of isoniazid resistance and genetic mutations in isoniazid-resistant and rifampicin-susceptible Mycobacterium tuberculosis in China","authors":"Dongxin Liu ,&nbsp;Bing Zhao ,&nbsp;Yang Zheng ,&nbsp;Xichao Ou ,&nbsp;Shengfen Wang ,&nbsp;Yang Zhou ,&nbsp;Yuanyuan Song ,&nbsp;Hui Xia ,&nbsp;Qiang Wei ,&nbsp;YanLin Zhao","doi":"10.1016/j.imj.2024.100129","DOIUrl":"10.1016/j.imj.2024.100129","url":null,"abstract":"<div><h3>Background</h3><p>Patients with tuberculosis resistant to isoniazid but susceptible to rifampicin (H<sup>r</sup>-R<sup>s</sup> TB) remain a neglected demographic, despite a high disease burden and poor outcomes of these patients. The aim of this study was to investigate the characteristics of isoniazid-resistance-related mutations in <em>Mycobacterium tuberculosis</em> and resistance rates to drugs included in WHO-recommended regimens for H<sup>r</sup>-R<sup>s</sup> patients.</p></div><div><h3>Methods</h3><p><em>Mycobacterium tuberculosis</em> isolates (<em>n</em> = 4922) obtained from national tuberculosis drug-resistance surveillance were subjected to whole-genome sequencing to identify H<sup>r</sup>-R<sup>s</sup> strains. The minimal inhibitory concentrations (MICs) were established for the H<sup>r</sup>-R<sup>s</sup> strains to determine the isoniazid resistance levels. We also identified drug-resistance-associated mutations for five drugs (fluoroquinolones, ethambutol, pyrazinamide, streptomycin, and amikacin) in the H<sup>r</sup>-R<sup>s</sup> strains.</p></div><div><h3>Results</h3><p>Of the 4922 strains, 384 (7.8 %) were H<sup>r</sup>-R<sup>s</sup>. The subculture of seven strains failed, so 377 (98.2 %) strains underwent phenotypic MIC testing. Among the 384 genotypic H<sup>r</sup>-R<sup>s</sup> strains, 242 (63.0 %) contained the <em>katG</em> Ser315Thr substitution; 115 (29.9 %) contained the -15C&gt;T in the promoter region of the <em>fabG1</em> gene; and 16 (4.2 %) contained Ser315Asn in the <em>katG</em> gene. Of the 239 strains with the Ser315Thr substitution, 229 (95.8 %) had MIC ≥ 2 µg/mL, and of the 114 strains with the -15C&gt;T mutation, 103 (90.4 %) had 0.25 µg/mL ≤ MIC ≤ 1 µg/mL. The genotypic resistance rates were 0.8 % (3/384) for pyrazinamide, 2.3 % (9/384) for ethambutol and fluoroquinolones; 39.6 % (152/384) of the strains were resistant to streptomycin, but only 0.5 % (2/384) of the strains were resistant to amikacin.</p></div><div><h3>Conclusion</h3><p>Ser315Thr in <em>katG</em> was the predominant mutation conferring the H<sup>r</sup>-R<sup>s</sup> phenotype, followed by the <em>fabG1</em> -15C&gt;T mutation. The combination of rifampicin, pyrazinamide, ethambutol, and levofloxacin should be effective in the treatment of patients with H<sup>r</sup>-R<sup>s</sup> tuberculosis because the resistance rates for these drugs in China are low.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X24000431/pdfft?md5=26b8dfceffc196520c45425a907da6a7&pid=1-s2.0-S2772431X24000431-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ocular tuberculosis associated with Epstein-Barr virus myelitis: A case report 伴有 Epstein-Barr 病毒脊髓炎的眼结核:病例报告
Infectious Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.imj.2024.100132
Fakhri Alahyari , Raheleh Halabian , Javad Hosseini Nejad
{"title":"Ocular tuberculosis associated with Epstein-Barr virus myelitis: A case report","authors":"Fakhri Alahyari ,&nbsp;Raheleh Halabian ,&nbsp;Javad Hosseini Nejad","doi":"10.1016/j.imj.2024.100132","DOIUrl":"10.1016/j.imj.2024.100132","url":null,"abstract":"<div><p>Ocular tuberculosis (OTB) is a chronic eye infection caused by <em>Mycobacterium tuberculosis</em>. Some cases of myelitis are associated with <em>Epstein-Barr virus</em> (EBV), with 1-5% of EBV infections leading to neurologic complications. We describe a 34-year-old Iranian woman with OTB and EBV coinfection. Despite initial success with anti-TB agents, the disease progressed, necessitating enucleation. <em>Mycobacterium tuberculosis</em> was detected by a tuberculin coagulation test, and EBV was confirmed via polymerase chain reaction. MRI showed plaques in the spinal cord and brain. The patient was treated with anti-TB and antiretroviral agents. Recognizing TB in the differential diagnosis of EBV myelitis is crucial.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X24000467/pdfft?md5=3bd8069dc0ad02ebfc30d16a4483f1e4&pid=1-s2.0-S2772431X24000467-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery: A 10-year surveillance study in a Chinese tertiary hospital 神经外科呼吸机相关肺炎的流行病学特征:一家中国三级医院的十年监测研究
Infectious Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.imj.2024.100128
Zhenghao Yu , Xinlou Li , Chenglong Lv , Yao Tian , Jijiang Suo , Zhongqiang Yan , Yanling Bai , Bowei Liu , Liqun Fang , Mingmei Du , Hongwu Yao , Yunxi Liu
{"title":"Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery: A 10-year surveillance study in a Chinese tertiary hospital","authors":"Zhenghao Yu ,&nbsp;Xinlou Li ,&nbsp;Chenglong Lv ,&nbsp;Yao Tian ,&nbsp;Jijiang Suo ,&nbsp;Zhongqiang Yan ,&nbsp;Yanling Bai ,&nbsp;Bowei Liu ,&nbsp;Liqun Fang ,&nbsp;Mingmei Du ,&nbsp;Hongwu Yao ,&nbsp;Yunxi Liu","doi":"10.1016/j.imj.2024.100128","DOIUrl":"10.1016/j.imj.2024.100128","url":null,"abstract":"<div><h3>Background</h3><p>Ventilator-associated pneumonia (VAP) is a significant and common health concern. The epidemiological landscape of VAP is poorly understood in neurosurgery patients. This study aimed to explore the epidemiology of VAP in this population and devise targeted surveillance, treatment, and control efforts.</p></div><div><h3>Methods</h3><p>A 10-year retrospective study spanning 2011 to 2020 was performed in a large Chinese tertiary hospital. Surveillance data was collected from neurosurgical patients and analyzed to map the demographic and clinical characteristics of VAP and describe the distribution and antimicrobial resistance profile of leading pathogens. Risk factors associated with the presence of VAP were explored using boosted regression tree (BRT) models.</p></div><div><h3>Results</h3><p>Three hundred ten VAP patients were identified. The 10-year incidence of VAP was 16.21 per 1000 ventilation days. All-cause mortality was 6.1%. The prevalence of gram-negative bacteria, fungi, and gram-positive bacteria among the 357 organisms isolated from VAP patients was 86.0%, 7.6%, and 6.4%, respectively; most were multidrug-resistant organisms. <em>Acinetobacter baumannii, Klebsiella pneumoniae</em>, and <em>Pseudomonas aeruginosa</em> were the most common pathogens. The prevalence of carbapenem-resistant <em>A. baumannii, P. aeruginosa,</em> and <em>K. pneumoniae</em> was high and increased over time in the study period. The BRT models revealed that VAP was associated with number of days of ventilator use (relative contribution, 47.84 ± 7.25), Glasgow Coma Scale score (relative contribution, 24.72 ± 5.67), and tracheotomy (relative contribution, 21.50 ± 2.69).</p></div><div><h3>Conclusions</h3><p>Our findings provide a better understanding of the epidemiology of VAP and its risk factors in neurosurgery patients.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X2400042X/pdfft?md5=1f910e6f40248a5c95744cd1bd21f27c&pid=1-s2.0-S2772431X2400042X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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