Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study
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 utilize...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s13613-025-01462-y |
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| author | Luis Felipe Reyes Natalia Sanabria-Herrera Saad Nseir Otavio T. Ranzani Pedro Povoa Emilio Diaz Marcus J. Schultz Alejandro Rodríguez Cristian C. Serrano-Mayorga Gennaro De Pascale Paolo Navalesi Szymon Skoczynski Mariano Esperatti Luis Miguel Coelho Andrea Cortegiani Stefano Aliberti Anselmo Caricato Helmut J. F. Salzer Adrian Ceccato Rok Civljak Paolo Maurizio Soave Charles-Edouard Luyt Pervin Korkmaz Ekren Fernando Rios Joan Ramon Masclans Judith Marin Silvia Iglesias-Moles Stefano Nava Davide Chiumello Lieuwe D. J. Bos Antonio Artigas Filipe Froes David Grimaldi Mauro Panigada Fabio Silvio Taccone Massimo Antonelli Antoni Torres Ignacio Martin-Loeches for the European Network for ICU-Related Respiratory Infections (ENIRRIs) European Respiratory Society-Clinical Research Collaboration Investigators |
| author_facet | Luis Felipe Reyes Natalia Sanabria-Herrera Saad Nseir Otavio T. Ranzani Pedro Povoa Emilio Diaz Marcus J. Schultz Alejandro Rodríguez Cristian C. Serrano-Mayorga Gennaro De Pascale Paolo Navalesi Szymon Skoczynski Mariano Esperatti Luis Miguel Coelho Andrea Cortegiani Stefano Aliberti Anselmo Caricato Helmut J. F. Salzer Adrian Ceccato Rok Civljak Paolo Maurizio Soave Charles-Edouard Luyt Pervin Korkmaz Ekren Fernando Rios Joan Ramon Masclans Judith Marin Silvia Iglesias-Moles Stefano Nava Davide Chiumello Lieuwe D. J. Bos Antonio Artigas Filipe Froes David Grimaldi Mauro Panigada Fabio Silvio Taccone Massimo Antonelli Antoni Torres Ignacio Martin-Loeches for the European Network for ICU-Related Respiratory Infections (ENIRRIs) European Respiratory Society-Clinical Research Collaboration Investigators |
| author_sort | Luis Felipe Reyes |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e035971c43fc43dfa868adeb97a9f7e4 |
| institution | OA Journals |
| issn | 2110-5820 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
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| series | Annals of Intensive Care |
| spelling | doaj-art-e035971c43fc43dfa868adeb97a9f7e42025-08-20T02:15:15ZengSpringerOpenAnnals of Intensive Care2110-58202025-05-0115111310.1186/s13613-025-01462-yNosocomial lower respiratory tract infections in patients with immunosuppression: a cohort studyLuis Felipe Reyes0Natalia Sanabria-Herrera1Saad Nseir2Otavio T. Ranzani3Pedro Povoa4Emilio Diaz5Marcus J. Schultz6Alejandro Rodríguez7Cristian C. Serrano-Mayorga8Gennaro De Pascale9Paolo Navalesi10Szymon Skoczynski11Mariano Esperatti12Luis Miguel Coelho13Andrea Cortegiani14Stefano Aliberti15Anselmo Caricato16Helmut J. F. Salzer17Adrian Ceccato18Rok Civljak19Paolo Maurizio Soave20Charles-Edouard Luyt21Pervin Korkmaz Ekren22Fernando Rios23Joan Ramon Masclans24Judith Marin25Silvia Iglesias-Moles26Stefano Nava27Davide Chiumello28Lieuwe D. J. Bos29Antonio Artigas30Filipe Froes31David Grimaldi32Mauro Panigada33Fabio Silvio Taccone34Massimo Antonelli35Antoni Torres36Ignacio Martin-Loeches37for the European Network for ICU-Related Respiratory Infections (ENIRRIs) European Respiratory Society-Clinical Research Collaboration InvestigatorsUnisabana Center for Translational Science, School of Medicine, Universidad de La SabanaUnisabana Center for Translational Science, School of Medicine, Universidad de La SabanaUniversity Hospital of LilleBarcelona Institute for Global Health, ISGlobal, Hospital Clínic-Universitat de BarcelonaNOVA Medical School, NOVA University of LisbonCorporacio Sanitaria Parc TauliIntensive Care, Amsterdam UMC, University of AmsterdamHospital Joan XXIII de TarragonaUnisabana Center for Translational Science, School of Medicine, Universidad de La SabanaDepartment of Intensive Care and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS RomeMagna Graecia UniversityDepartment of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of SilesiaHospital Privado de Comunidad, Escuela Superior de Medicina, Universidad Nacional de Mar del PlataHospital de Sao Francisco XavierDepartment of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of PalermoMedical University of SilesiaDepartment of Intensive Care and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS RomeDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4 - Pneumology, Kepler University HospitalCritical Care Center, Hospital Universitari Parc Taulí, Institut d’Investigació I Innovació Parc Taulí (I3PT-CERCA)University of Zagreb School of MedicineDepartment of Intensive Care and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS RomeSorbonne Université, Service de Médecine Intensive Réanimation, Groupe Hospitalier Pitié-Salpêtriere, Assistance Publique–Hôpitaux de ParisEge University Medical FacultyHospital Nacional Alejandro PosadasCritical Care Department, Hospital del Mar, GREPAC, Hospital del Mar Research Institute, MELIS, Universitat Pompeu FabraHospital del MarHospital Arnau de Vilanova de LleidaAlma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of BolognaASST Santi Paolo e CarloIntensive Care, Amsterdam UMC, University of AmsterdamIntensive Care Medicine Department, Corporacion Sanitaria Universitaria Parc Tauli, Institut d´Investigació I Innovació Parc Tauli I3PT, CIBER Enfermedades Respiratorias, Autonomous University of BarcelonaChest Department, Hospital Pulido Valente, CHULNHopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB)Anesthesia and Critical Care, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoHopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB)Department of Intensive Care and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS RomeHospital Clinic of Barcelona James’s University Hospital, Trinity CollegeAbstract 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.https://doi.org/10.1186/s13613-025-01462-yImmunosuppressionNosocomial lower respiratory tract infectionsCritical care |
| spellingShingle | Luis Felipe Reyes Natalia Sanabria-Herrera Saad Nseir Otavio T. Ranzani Pedro Povoa Emilio Diaz Marcus J. Schultz Alejandro Rodríguez Cristian C. Serrano-Mayorga Gennaro De Pascale Paolo Navalesi Szymon Skoczynski Mariano Esperatti Luis Miguel Coelho Andrea Cortegiani Stefano Aliberti Anselmo Caricato Helmut J. F. Salzer Adrian Ceccato Rok Civljak Paolo Maurizio Soave Charles-Edouard Luyt Pervin Korkmaz Ekren Fernando Rios Joan Ramon Masclans Judith Marin Silvia Iglesias-Moles Stefano Nava Davide Chiumello Lieuwe D. J. Bos Antonio Artigas Filipe Froes David Grimaldi Mauro Panigada Fabio Silvio Taccone Massimo Antonelli Antoni Torres Ignacio Martin-Loeches for the European Network for ICU-Related Respiratory Infections (ENIRRIs) European Respiratory Society-Clinical Research Collaboration Investigators Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study Annals of Intensive Care Immunosuppression Nosocomial lower respiratory tract infections Critical care |
| title | Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study |
| title_full | Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study |
| title_fullStr | Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study |
| title_full_unstemmed | Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study |
| title_short | Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study |
| title_sort | nosocomial lower respiratory tract infections in patients with immunosuppression a cohort study |
| topic | Immunosuppression Nosocomial lower respiratory tract infections Critical care |
| url | https://doi.org/10.1186/s13613-025-01462-y |
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