Seminars in Respiratory and Critical Care Medicine Seminars in Respiratory and Critical Care Medicine RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Viral Ventilator-Associated Pneumonia/Hospital-Acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740981Among the viruses possibly responsible for hospital-acquired and ventilator-associated pneumonia, herpes simplex virus (HSV) is probably the most often involved: HSV reactivation is frequent in intensive care unit patients, and lung parenchymal infection (HSV bronchopneumonitis) has been well described, either using cytological signs of parenchymal involvement in cells obtained during bronchoalveolar lavage or using HSV virus load in the lower respiratory tract. Although treating patients with HSV bronchopneumonitis may be recommended, based on expert opinion, prophylac...
Source: Seminars in Respiratory and Critical Care Medicine - January 31, 2022 Category: Respiratory Medicine Authors: Luyt, Charles-Edouard H ékimian, Guillaume Br échot, Nicolas Chastre, Jean Tags: Review Article Source Type: research

New Insights in the Pathophysiology of Hospital- and Ventilator-Acquired Pneumonia: A Complex Interplay between Dysbiosis and Critical-Illness –Related Immunosuppression
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740606Both hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) have long been considered as diseases resulting from the invasion by pathogens of a previously sterile lung environment. Based on this historical understanding of their pathophysiology, our approaches for the prevention and treatment have significantly improved the outcomes of patients, but treatment failures remain frequent. Recent studies have suggested that the all-antimicrobial therapy-based treatment of pneumonia has reached a glass ceiling. The demonstration that the constant interact...
Source: Seminars in Respiratory and Critical Care Medicine - January 31, 2022 Category: Respiratory Medicine Authors: Bourdiol, A. Roquilly, A. Tags: Review Article Source Type: research

Defining Clinical and Microbiological Nonresponse in Ventilator-Associated Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740584Ventilator-associated pneumonia (VAP) is a severe complication of mechanical ventilation, with mortality reduced most effectively by adequate early antibiotic treatment. The clinical and microbiologic response can be assessed easily from 72 hours after starting antibiotic treatment. Evidence of nonresponse is based on several factors: (1) lack of clinical improvement, (2) radiographic progression, (3) an impaired Sequential Organ Failure Assessment (SOFA) score, (4) no improvement by days 3 to 5 on the Clinical Pulmonary Infection Score (CPIS), (5) no decreased in bio...
Source: Seminars in Respiratory and Critical Care Medicine - January 27, 2022 Category: Respiratory Medicine Authors: Ceccato, Adrian Torres, Antoni Tags: Review Article Source Type: research

New Antibiotics for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740605Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) represent one of the most common hospital-acquired infections, carrying a significant morbidity and risk of mortality. Increasing antibiotic resistance among the common bacterial pathogens associated with HAP and VAP, especially Enterobacterales and nonfermenting gram-negative bacteria, has made the choice of empiric treatment of these infections increasingly challenging. Moreover, failure of initial empiric therapy to cover the causative agents associated with HAP and VAP has been associated wi...
Source: Seminars in Respiratory and Critical Care Medicine - January 27, 2022 Category: Respiratory Medicine Authors: Bassetti, Matteo Mularoni, Alessandra Giacobbe, Daniele Roberto Castaldo, Nadia Vena, Antonio Tags: Review Article Source Type: research

Pharmacokinetic/Pharmacodynamic Optimization of Hospital-Acquired and Ventilator-Associated Pneumonia: Challenges and Strategies
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1742105Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are correlated with high mortality rates worldwide. Thus, the administration of antibiotic therapy with appropriate dosing regimen is critical. An efficient antibiotic is needed to maintain an adequate concentration at the infection site, for a sufficient period of time, to achieve the best therapeutic outcome. It can, however, be challenging for antibiotics to penetrate the pulmonary system due to the complexity of its structure. Crossing the blood alveolar barrier is a difficult process determ...
Source: Seminars in Respiratory and Critical Care Medicine - January 27, 2022 Category: Respiratory Medicine Authors: Abouelhassan, Yasmeen P. Nicolau, David Tags: Review Article Source Type: research

Pseudomonas aeruginosa Pneumonia: Evolution of Antimicrobial Resistance and Implications for Therapy
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740109 Pseudomonas aeruginosa (PA), a non–lactose-fermenting gram-negative bacillus, is a common cause of nosocomial infections in critically ill or debilitated patients, particularly ventilator-associated pneumonia (VAP), and infections of urinary tract, intra-abdominal, wounds, skin/soft tissue, and bloodstream. PA rarely affects healthy individuals, but may cause serious infections in patients with chronic structural lung disease, comorbidities, advanced age, impaired immune defenses, or with medical devices (e.g., urinary or intravascular catheters, foreign bodies)...
Source: Seminars in Respiratory and Critical Care Medicine - January 21, 2022 Category: Respiratory Medicine Authors: Lynch, Joseph P. Zhanel, George G. Tags: Review Article Source Type: research

Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia after Guidelines
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1742463 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - January 21, 2022 Category: Respiratory Medicine Authors: Martin-Loeches, Ignacio Torres, Antoni Tags: Preface Source Type: research

“HAP and VAP after Guidelines”
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740246Nosocomial pneumonia is associated with worsened prognosis when diagnosed in intensive care unit (ICU), ranging from 12 to 48% mortality. The incidence rate of ventilation-acquired pneumonia tends to decrease below 15/1,000 intubation-day. Still, international guidelines are heterogeneous about diagnostic criteria because of inaccuracy of available methods. New entities have thus emerged concerning lower respiratory tract infection, namely ventilation-acquired tracheobronchitis (VAT), or ICU-acquired pneumonia (ICUAP), eventually requiring invasive ventilation (v-ICUAP)...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Wicky, Paul-Henri Martin-Loeches, Ignacio Timsit, Jean-Fran çois Tags: Review Article Source Type: research

Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia and Ventilator-Associated Tracheobronchitis in COVID-19
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740334Although few studies evaluated the incidence of hospital-acquired pneumonia (HAP) or ventilator-associated tracheobronchitis in COVID-19 patients, several studies evaluated the incidence of ventilator-associated pneumonia (VAP) in these patients. Based on the results of a large multicenter European study, VAP incidence is higher in patients with SARS-CoV-2 pneumonia (36.1%), as compared with those with influenza pneumonia (22.2%), or no viral infection at intensive care unit (ICU) admission (16.5%). Potential explanation for the high incidence of VAP in COVID-19 patient...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Rouz é, Anahita Nseir, Saad Tags: Review Article Source Type: research

Classical and Molecular Techniques to Diagnose HAP/VAP
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1739359Nosocomial pneumonia, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), are the most common nosocomial infections occurring in critically ill patients requiring intensive care. However, challenges exist in making a timely and accurate diagnosis of HAP and VAP. Under diagnosis of HAP and VAP can result in greater mortality risk, especially if accompanied by delays in the administration of appropriate antimicrobial treatment. Over diagnosis of HAP and VAP results in the unnecessary administration of broad spectrum antibiotics that can ...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Renaud, Cherie Kollef, Marin H. Tags: Review Article Source Type: research

Risk Factors and Algorithms for the Empirical Treatment of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740335Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) continue to be major concerns for morbidity and mortality, especially in patients treated in the intensive care unit. With the rise in multidrug-resistant organisms, HAP and VAP treatment is challenged by the need for early appropriate treatment, with broad-spectrum agents, while still being aware of the principles of antibiotic stewardship. The two major society guidelines proposed a series of risk factors in their most recent guidelines to help identify patients who can most benefit from narro...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Pan, Di Niederman, Michael S. Tags: Review Article Source Type: research

New Insights into the Prevention of Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia Caused by Viruses
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740582A fifth or more of hospital-acquired pneumonias may be attributable to respiratory viruses. The SARS-CoV-2 pandemic has clearly demonstrated the potential morbidity and mortality of respiratory viruses and the constant threat of nosocomial transmission and hospital-based clusters. Data from before the pandemic suggest the same can be true of influenza, respiratory syncytial virus, and other respiratory viruses. The pandemic has also helped clarify the primary mechanisms and risk factors for viral transmission. Respiratory viruses are primarily transmitted by respiratory...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Klompas, Michael Tags: Review Article Source Type: research

Invasive Pulmonary Aspergillosis in Hospital and Ventilator-Associated Pneumonias
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1739472Pneumonia is the commonest nosocomial infection complicating hospital stay, with both non-ventilated hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) occurring frequently amongst patients in intensive care. Aspergillus is an increasingly recognized pathogen amongst patients with HAP and VAP, and is associated with significantly increased mortality if left untreated.Invasive pulmonary aspergillosis (IPA) was originally identified in patients who had been profoundly immunosuppressed, however, this disease can also occur in patients with relative...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Chen, Fangyue Qasir, Danyal Morris, Andrew Conway Tags: Review Article Source Type: research

Nebulized Antibiotics for Healthcare- and Ventilator-Associated Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0041-1740340Global emergence of multidrug-resistant and extensive drug-resistant gram-negative bacteria has increased the risk of treatment failure, especially for healthcare- or ventilator-associated pneumonia (HAP/VAP). Nebulization of antibiotics, by providing high intrapulmonary antibiotic concentrations, represents a promising approach to optimize the treatment of HAP/VAP due to multidrug-resistant and extensive drug-resistant gram-negative bacteria, while limiting systemic antibiotic exposure. Aminoglycosides and colistin methanesulfonate are the most common nebulized antibio...
Source: Seminars in Respiratory and Critical Care Medicine - January 18, 2022 Category: Respiratory Medicine Authors: Boisson, Matthieu Bougl é, Adrien Sole-Lleonart, Candela Dhanani, Jayesh Arvaniti, Kostoula Rello, Jordi Rouby, Jean-Jacques Mimoz, Olivier Tags: Review Article Source Type: research

Antiviral Treatments for Influenza
Semin Respir Crit Care Med 2021; 42: 859-872 DOI: 10.1055/s-0041-1733830Influenza is an acute respiratory illness caused by the influenza A, B, and C viruses. It can occur in local outbreaks or seasonal epidemics, with possibility to spread worldwide in a pandemic when a novel strain with significant antigenic differences emerges. During the past years, several new drugs have become available, with different accessibility related to specific countries' approval. We have conducted a review of literature, analyzing the most recent data on efficacy and safety of drugs currently available to treat influenza, with a particular ...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Palomba, Emanuele Castelli, Valeria Renisi, Giulia Bandera, Alessandra Lombardi, Andrea Gori, Andrea Tags: Review Article Source Type: research