TY - JOUR
T1 - Differences in hospital- and ventilator-associated pneumonia due to Staphylococcus aureus (methicillin-susceptible and methicillin-resistant) between Europe and Latin America
T2 - A comparison of the EUVAP and LATINVAP study cohorts
AU - Rello, J.
AU - Molano, D.
AU - Villabon, M.
AU - Reina, R.
AU - Rita-Quispe, R.
AU - Previgliano, I.
AU - Afonso, E.
AU - Restrepo, M. I.
N1 - Funding Information:
Supported in part with an unrestricted educational grant from Pfizer S.L.U., Madrid, Spain. EUVAP and LATINVAP were ECCRN endorsed projects by the ESICM. These projects are also part of the PCI of Pneumonia in the CIBERES Network, Instituto Salud Carlos III – Spain. Dr. Restrepo's time is partially protected by Award Number K23HL096054, from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health.
Funding Information:
Jordi Rello serves as member of the Advisory Boards and Speaking Bureaus of Pfizer and Astellas. Jordi Rello has received research grant support from Pfizer. Dr. Marcos I. Restrepo participated in advisory boards for Theravance, Forest Laboratories, Johnson & Johnson, Trius and Novartis. Consultant for Theravance, Trius and Pfizer (Wyeth).
PY - 2013/5
Y1 - 2013/5
N2 - Purpose: A comparison is made of epidemiological variables (demographic and clinical characteristics) and outcomes in patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) in the Latin American VAP (LATINVAP) vs. the European Union VAP (EUVAP) cohorts of patients admitted to intensive care units (ICUs). Methods: The EUVAP project was a prospective, multicenter observational study reporting 827 patients with HAP/VAP in 27 ICUs from 9 European countries. The LATINVAP project was a multicenter prospective observational study, with an identical design, performed in 17 ICUs from 4 Latin American countries involving 99 patients who developed HAP/VAP. Episodes of VAP/HAP caused by S. aureus, MSSA, and MRSA were compared in both cohorts. Results: Forty-five patients had S. aureus HAP/VAP in the EUVAP cohort vs. 11 patients in the LATINVAP cohort. More patients had MRSA in the LATINVAP study than in the EUVAP (45% vs. 33%). ICU mortality among patients with MSSA HAP/VAP in EUVAP was 10% vs. 50% for LATINVAP (OR=9.75, p=0.01). Fifteen patients in the EUVAP cohort developed MRSA HAP/VAP as opposed to 5 in LATINVAP. In the EUVAP study there was an ICU mortality rate of 33.3%. In the LATINVAP cohort, the ICU mortality rate was 60% (OR for death=3.0; 95%CI 0.24-44.7). Conclusion: MRSA pneumonia was associated with poorer outcomes in comparison with MSSA. Our study suggests significant variability among European and Latin American ICU practices that may influence clinical outcomes. Furthermore, patients with pneumonia in Latin America have different outcomes.
AB - Purpose: A comparison is made of epidemiological variables (demographic and clinical characteristics) and outcomes in patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) in the Latin American VAP (LATINVAP) vs. the European Union VAP (EUVAP) cohorts of patients admitted to intensive care units (ICUs). Methods: The EUVAP project was a prospective, multicenter observational study reporting 827 patients with HAP/VAP in 27 ICUs from 9 European countries. The LATINVAP project was a multicenter prospective observational study, with an identical design, performed in 17 ICUs from 4 Latin American countries involving 99 patients who developed HAP/VAP. Episodes of VAP/HAP caused by S. aureus, MSSA, and MRSA were compared in both cohorts. Results: Forty-five patients had S. aureus HAP/VAP in the EUVAP cohort vs. 11 patients in the LATINVAP cohort. More patients had MRSA in the LATINVAP study than in the EUVAP (45% vs. 33%). ICU mortality among patients with MSSA HAP/VAP in EUVAP was 10% vs. 50% for LATINVAP (OR=9.75, p=0.01). Fifteen patients in the EUVAP cohort developed MRSA HAP/VAP as opposed to 5 in LATINVAP. In the EUVAP study there was an ICU mortality rate of 33.3%. In the LATINVAP cohort, the ICU mortality rate was 60% (OR for death=3.0; 95%CI 0.24-44.7). Conclusion: MRSA pneumonia was associated with poorer outcomes in comparison with MSSA. Our study suggests significant variability among European and Latin American ICU practices that may influence clinical outcomes. Furthermore, patients with pneumonia in Latin America have different outcomes.
KW - Methicillin-resistant Staphylococcus aureus
KW - Pneumonia
KW - Respiratory infections
KW - Staphylococcus aureus
KW - Ventilator-associated pneumonia
UR - http://www.scopus.com/inward/record.url?scp=84892446039&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84892446039&partnerID=8YFLogxK
U2 - 10.1016/j.medin.2012.04.008
DO - 10.1016/j.medin.2012.04.008
M3 - Article
C2 - 22749536
AN - SCOPUS:84892446039
SN - 0210-5691
VL - 37
SP - 241
EP - 247
JO - Medicina Intensiva
JF - Medicina Intensiva
IS - 4
ER -