PREdiction of CEphalosporinase Producing Enterobacteria During Ventilator-associated Pneumonia for Therapeutic Stewardship

Fondation Hôpital Saint-Joseph345 enrolled

Overview

Ventilator-associated pneumonia is the leading cause of nosocomial infection in the ICU. Cephalosporinase-producing Enterobacteriaceae have an increasing incidence. Infections in cephalosporinase-producing patients require the use of Cefepime during probabilistic antibiotic therapy, the repeated use of which will lead to a significant risk of selection of resistant mutants. The involvement of cephalosporinases being infrequent, the prediction of their presence during a VAP would make it possible to reduce the consumption of Cefepime and thus to take part in the prevention of selection of bacterial mutants resistant to beta-lactams. The main objective of the research is to determine the risk factors for the involvement of cephalosporinase-producing enterobacteria during episodes of ventilator-associated pneumonia (VAP) in hospitalized patients. The secondary objectives are to describe the epidemiology of cephalosporinase-producing enterobacteria in the ICU and to compare the risk factors for the presence of a cephalosporinase-producing germ not without its production being derepressed with those present in situations of cephalosporinase derepression.

Study Type

OBSERVATIONAL

Enrollment

345

Conditions

Ventilator Associated Pneumonia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient 18 years and older * Patient on mechanical ventilation for more than 48 hours * Patient with a diagnosis of ventilator-associated lung disease during management according to American Thoracic Society criteria * French speaking patient Exclusion Criteria: * Tracheostomized patient at the time of inclusion * Limitation of therapies before inclusion in the study * Patient under guardianship or curatorship * Patient deprived of liberty * Patient under court protection * Patient objecting to the use of his/her data for this research

Outcomes

Primary Outcomes

Prevalence of cephalosporinase-producing enterobacteria during episodes of ventilator-associated pneumonia

This outcome corresponds to the the number of ventilator-associated pneumonias involving cephalosporinase-producing enterobacteria.

Time frame: 1 month

Secondary Outcomes

Epidemiology of cephalosporinase-carrying enterobacteria in the ICU

This outcome corresponds to the number of pathogens identified in ventilator-associated pneumonia.