Nosocomial lower respiratory tract infections in patients with immunosuppression : a cohort study
Reyes, L.F. (University of Oxford)
Sanabria-Herrera, N. (Clinica Universidad de La Sabana)
Nseir, Saad (University Hospital of Lille (França))
Ranzani, O.T. (Universidade de São Paulo)
Povoa, P. (Hospital de São Francisco Xavier (Lisboa, Portugal))
Díaz Santos, Emilio (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Schultz, M. J. (Laboratory for Experimental Intensive Care & Anesthesiology (L E I C A))
Rodríguez, A. (Hospital Universitari Joan XXIII de Tarragona)
Serrano-Mayorga, C.C. (Universidad de La Sabana)
De Pascale, G. (Fondazione Policlinico Universitario A. Gemelli IRCCS)
Navalesi, P. (Sant'Andrea (ASL VC))
Skoczynski, S. (Medical University of Silesia)
Esperatti, M. (Universidad Nacional de Mar del Plata)
Coelho, L.M. (Hospital de Sao Francisco Xavier)
Cortegiani, Andrea (Policlinico Paolo Giaccone)
Aliberti, S. (Humanitas Research Hospital (Itàlia))
Caricato, A. (Fondazione Policlinico Universitario A. Gemelli IRCCS Rome)
Salzer, H.J.F. (Ignaz Semmelweis Institute. Interuniversity Institute for Infection Research)
Ceccato, Adrian (Hospital Universitari Vall d'Hebron)
Civljak, R. (University of Zagreb School of Medicine)
Soave, P.M. (Fondazione Policlinico Universitario A. Gemelli IRCCS Rome)
Luyt, Charles-Edouard (Sorbonne Université)
Ekren, P.K. (Ege University Medical Faculty)
Rios, Fernando (Hospital Nacional Alejandro Posadas)
Masclans, Joan R. (Institut Hospital del Mar d'Investigacions Mèdiques)
Marin, Judith (Institut Hospital del Mar d'Investigacions Mèdiques)
Iglesias-Moles, S. (Hospital Universitari Arnau de Vilanova (Lleida))
Nava, S. (Sant'Orsola Hospital)
Chiumello, D. (ASST Santi Paolo e Carlo)
Bos, Lieuwe D. (University of Amsterdam)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Froes, F. (Hospital Pulido Valente)
Grimaldi, D. (Hopital Universitaire de Bruxelles (HUB))
Panigada, M. (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia))
Taccone, F.S. (Hopital Universitaire de Bruxelles (HUB))
Antonelli, M. (Fondazione Policlinico Universitario A. Gemelli IRCCS Rome)
Torres, Antoni (Hospital Clínic i Provincial de Barcelona)
Martin-Loeches, Ignacio (James's University Hospital)
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Background: This post-hoc analysis of a multinational, multicenter study aimed to describe and compare clinical characteristics, microbiology, and outcomes between immunosuppressed and non-immunosuppressed patients with nosocomial lower respiratory tract infections (nLRTI). The study utilized data from the European Network for ICU-related Respiratory Infections, including 1,060 adult ICU patients diagnosed with nLRTI. Descriptive statistics were used to compare baseline characteristics and pathogen distribution between groups. A Cox proportional hazards model stratified by immunosuppression status was applied to assess 28-day mortality risk, adjusting for disease severity and key clinical variables. Results: Immunosuppression was observed in 24. 9% (264/1060) of the patients, and oncological conditions were the most common etiology of immunosuppression. Chronic pulmonary and cardiovascular diseases were the most frequent comorbidities. In both groups, Pseudomonas aeruginosa was the predominant microorganism, particularly affecting patients with immunosuppression (25. 3% vs. 16. 7%, p = 0. 032). Cox regression model adjusted for disease severity (SAPS II), polytraumatized status, altered consciousness, and postoperative status, SAPS II remained a strong independent predictor of mortality, with each one-point increase associated with a 2. 3% higher risk of death (HR: 1. 023, 95% CI 1. 017-1. 030, p < 0. 001). The analysis also revealed significant heterogeneity in mortality risk among immunosuppressed patients, with hematological malignancies, recent chemotherapy, and bone marrow transplantation associated with the highest mortality. Conclusions: Immunosuppressed patients had a lower adjusted survival probability compared to non-immunosuppressed patients. Moreover, P. aeruginosa was the most frequently identified etiological pathogen in immunosuppressed patients.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Critical care ; Immunosuppression ; Nosocomial lower respiratory tract infections
Published in:	Annals of Intensive Care, Vol. 15 Núm. 1 (december 2025) , p. 61, ISSN 2110-5820

DOI: 10.1186/s13613-025-01462-y
PMID: 40328994

13 p, 1.9 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles