Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;28(1):193-200.
doi: 10.1007/s00520-019-04800-6. Epub 2019 Apr 17.

Ventilator-associated pneumonia and bloodstream infections in intensive care unit cancer patients: a retrospective 12-year study on 3388 prospectively monitored patients

A Stoclin  1   2 , F Rotolo  3   4 , Y Hicheri  5 , M Mons  6 , E Chachaty  7 , B Gachot  5 , J-P Pignon  3   4 , M Wartelle  8 , F Blot  5
Affiliations

Ventilator-associated pneumonia and bloodstream infections in intensive care unit cancer patients: a retrospective 12-year study on 3388 prospectively monitored patients

A Stoclin et al. Support Care Cancer. 2020 Jan.

Abstract

Purpose: Some publications suggest high rates of healthcare-associated infections (HAIs) and of nosocomial pneumonia portending a poor prognosis in ICU cancer patients. A better understanding of the epidemiology of HAIs in these patients is needed.

Methods: A retrospective analysis of all the patients hospitalized for ≥ 48 h during a 12-year period in the 12-bed ICU of the Gustave Roussy hospital, monitored prospectively for ventilator-associated pneumonia (VAP) and bloodstream infection (BSI) and for use of medical devices.

Results: During 3388 first stays in the ICU, 198 cases of VAP and 103 primary, 213 secondary, and 77 catheter-related BSIs were recorded. The VAP rate was 24.5/1000 ventilator days (95% confidence interval [CI] 21.2-28.0); the catheter-related BSI rate was 2.3/1000 catheter days (95% CI 1.8-2.8). The cumulative incidence during the first 25 days of exposure was 58.8% (95% CI 49.1-66.6%) for VAP, 8.9% (95% CI, 6.2-11.5%) for primary, 15.1% (95% CI 11.6-18.5%) for secondary and 5.0% (95% CI 3.2-6.8%) for catheter-related BSIs. VAP or BSIs were not associated with a higher risk of ICU mortality.

Conclusions: This is the first study to report HAI rates in a large cohort of critically ill cancer patients. Although both the incidence of VAP and the rate of BSI are higher than in general ICU populations, this does not impact patient outcomes. The occurrence of device-associated infections is essentially due to severe medical conditions in patients and to the characteristics of malignancy.

Keywords: Catheter-associated infections; Healthcare-associated infections; Intensive care unit; Risk factors; Ventilator-associated pneumonia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Device utilization in the ICU at Gustave Roussy Hospital between 2000 and 2011
Fig. 2
Fig. 2
Cumulative incidence of intensive care unit associated infection in the first 25 days of exposure. Black lines are one minus the Kaplan–Meier estimator, with their 95% confidence bands. Red lines are the exponential estimator, under the hypothesis of constant risk over time. In all these cases, the hypothesis of constant risk over time is compatible with 95% confidence bands of the non-parametric Kaplan–Meier curves
Fig. 3
Fig. 3
Number of first stays in the intensive care unit (total = 3388) with at least one of each type of infection. VAP ventilator-associated pneumonia, pBSI primary bloodstream infections, sBSI secondary bloodstream infections, CR-BSI catheter-related bloodstream infections
See this image and copyright information in PMC

References

    1. Jarvis WR, Edwards JR, Culver DH, Hughes JM, Horan T, Emori TG, Banerjee S, Tolson J, Henderson T, Gaynes RP, Martone WJ, National Nosocomial Infections Surveillance System Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med. 1991;91:185S–191S. doi: 10.1016/0002-9343(91)90367-7. - DOI - PubMed
    1. Vincent JL, Bihari DJ, Suter PM, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) study. EPIC International Advisory Committee. JAMA. 1995;274:639–644. doi: 10.1001/jama.1995.03530080055041. - DOI - PubMed
    1. Azoulay E, Soares M, Darmon M, Benoit D, Pastores S, Afessa B. Intensive care of the cancer patient: recent achievements and remaining challenges. Ann Intensive Care. 2011;1:5. doi: 10.1186/2110-5820-1-5. - DOI - PMC - PubMed
    1. Velasco E, Thuler LC, Martins CA, et al. Nosocomial infections in an oncology intensive care unit. Am J Infect Control. 1997;25:458–462. doi: 10.1016/S0196-6553(97)90067-5. - DOI - PubMed
    1. Hoheisel G, Lange S, Winkler J, Rodloff AC, Liebert UG, Niederwieser D, Schauer J, Engelmann L. Nosocomial pneumonia in haematological malignancies in the medical intensive care unit. Pneumologie. 2003;57:73–77. doi: 10.1055/s-2003-37152. - DOI - PubMed

MeSH terms