Sleziak Jakub, Pilarczyk Katarzyna, Matysiak Michal, Duszynska Wieslawa
The Students Scientific Association by Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland.
Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland.
J Clin Med. 2024 May 10;13(10):2824. doi: 10.3390/jcm13102824.
During and after the COVID-19 pandemic, there was a suspicion of varying rates of respiratory tract infections (RTIs), particularly pneumonia (PN). : This research evaluated epidemiological indicators of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the COVID-19 pandemic and post-pandemic period, including pathogens, ventilator-associated pneumonia (VAP), selected risk factors, and PN mortality. : At 1740 patients, throughout the 22,774 patient-days (Pt-D) and 18,039 ventilation days (Vt-D), there were 681 PN cases (39.14%): CAP 336 (19.31%) and HAP 345 (19.83%). CAP caused by SARS-CoV-2 was diagnosed in 257/336 (76.49%) patients. The clinical manifestations of PNs were CAP with 336/681 (49.34%), VAP with 232/681 (34.07%), and non-ventilator HAP (NV-HAP) with 113/681 cases (16.59%). The incidence rate of CAP/1000 Pt-D has been over 3 times higher in the pandemic period of 2020-2021 (20.25) than in the post-pandemic period of 2022 (5.86), = 0.000. Similarly, higher incidence rates of VAP/1000 Pt-D were found in the pandemic period ( = 0.050). For NV-HAP, this difference was not statistically significant ( = 0.585). VAP occurred more frequently in the group of patients with PN in the course of COVID-19 compared to patients without COVID-19 (52/234 [22.2%] vs. 180/1506 [11.95%]); ( = 0.000). The most common CAP pathogen (during the pandemic) was SARS CoV-2 234/291 (80.4%), followed by MSSA/MRSA 8/291 (2.75%), whereas the most common VAP/NV-HAP pathogen was XDR/MDR. The highest PN mortality was found in the patients with CAP caused by SARS-CoV-2 159/257 (61.87%). : Pneumonias were diagnosed in nearly 40% of Intensive Care Unit (ICU) patients. Surveillance of pneumonias during the specific observation period was beneficial in the epidemiological and microbiological analysis of the ICU patients.
在新冠疫情期间及之后，人们怀疑呼吸道感染（RTIs）的发病率有所不同，尤其是肺炎（PN）。本研究评估了新冠疫情期间及疫情后社区获得性肺炎（CAP）和医院获得性肺炎（HAP）的流行病学指标，包括病原体、呼吸机相关性肺炎（VAP）、选定的危险因素和PN死亡率。在1740名患者中，在22774个患者日（Pt-D）和18039个通气日（Vt-D）期间，有681例PN病例（39.14%）：CAP 336例（19.31%），HAP 345例（19.83%）。在336例CAP患者中，257例（76.49%）被诊断为由SARS-CoV-2引起。PN的临床表现为CAP 336/681（49.34%）、VAP 232/681（34.07%）和非呼吸机相关性HAP（NV-HAP）113/681例（16.59%）。2020 - 2021年疫情期间CAP/1000 Pt-D的发病率（20.25）比2022年疫情后时期（5.86）高出3倍多，P = 0.000。同样，疫情期间VAP/1000 Pt-D的发病率也较高（P = 0.050）。对于NV-HAP，这种差异无统计学意义（P = 0.585）。与未感染新冠的患者相比，新冠患者中发生PN的患者组VAP更频繁（52/234 [22.2%] 对180/1506 [11.95%]）；（P = 0.000）。最常见（疫情期间）的CAP病原体是SARS CoV-2 234/291（80.4%），其次是MSSA/MRSA 8/291（2.75%），而最常见的VAP/NV-HAP病原体是广泛耐药/多重耐药菌。由SARS-CoV-2引起的CAP患者中PN死亡率最高，为159/257（61.87%）。近40%的重症监护病房（ICU）患者被诊断患有肺炎。在特定观察期内对肺炎进行监测有助于对ICU患者进行流行病学和微生物学分析。
