Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome
Suspicion of bacterial aspiration pneumonia (BAP) is frequent during generalized convulsive status epilepticus (GCSE). Early identification of BAP is required in order to avoid useless antibiotic therapy. In this retrospective monocentric study, we aimed to determine the incidence of aspiration synd...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/22/6673 |
| _version_ | 1797464941566885888 |
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| author | Romain Tortuyaux Frédéric Wallet Philippe Derambure Saad Nseir |
| author_facet | Romain Tortuyaux Frédéric Wallet Philippe Derambure Saad Nseir |
| author_sort | Romain Tortuyaux |
| collection | DOAJ |
| description | Suspicion of bacterial aspiration pneumonia (BAP) is frequent during generalized convulsive status epilepticus (GCSE). Early identification of BAP is required in order to avoid useless antibiotic therapy. In this retrospective monocentric study, we aimed to determine the incidence of aspiration syndrome and BAP in GCSE requiring mechanical ventilation (MV) and factors associated with the occurrence of BAP. Patients were older than 18 years and had GCSE requiring MV. To distinguish BAP from pneumonitis, tracheal aspirate and quantitative microbiological criterion were used. Out of 226 consecutive patients, 103 patients (46%) had an aspiration syndrome, including 54 (52%) with a BAP. <i>Staphylococcus aureus</i> represented 33% of bacterial strains. No relevant baseline characteristics differed, including serum levels of CRP, PCT, and albumin. The median duration of treatment for BAP was 7 days (5–7). Patients with BAP did not have a longer duration of MV (<i>p</i> = 0.18) and ICU stay (<i>p</i> = 0.18) than those with pneumonitis. At 3 months, 24 patients (44%) with BAP and 10 (27%) with pneumonitis had a poor functional outcome (<i>p</i> = 0.06). In conclusion, among patients with GCSE, half of the patients had an aspiration syndrome and one-quarter suffered from BAP. Clinical characteristics and biomarkers were not useful for differentiating BAP from pneumonitis. These results highlight the need for a method to rapidly differentiate BAP from pneumonitis, such as polymerase-chain-reaction-based techniques. |
| first_indexed | 2024-03-09T18:14:22Z |
| format | Article |
| id | doaj.art-08f88dfcdf19499482d2c08bdd015b5a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:14:22Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-08f88dfcdf19499482d2c08bdd015b5a2023-11-24T08:48:12ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011122667310.3390/jcm11226673Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and OutcomeRomain Tortuyaux0Frédéric Wallet1Philippe Derambure2Saad Nseir3Intensive Care Unit, CHU Lille, F-59000 Lille, FranceLaboratoire de Bactériologie-Hygiène, Centre de Biologie Pathologie, CHU Lille, F-59000 Lille, FranceDepartment of Clinical Neurophysiology, CHU Lille, F-59000 Lille, FranceIntensive Care Unit, CHU Lille, F-59000 Lille, FranceSuspicion of bacterial aspiration pneumonia (BAP) is frequent during generalized convulsive status epilepticus (GCSE). Early identification of BAP is required in order to avoid useless antibiotic therapy. In this retrospective monocentric study, we aimed to determine the incidence of aspiration syndrome and BAP in GCSE requiring mechanical ventilation (MV) and factors associated with the occurrence of BAP. Patients were older than 18 years and had GCSE requiring MV. To distinguish BAP from pneumonitis, tracheal aspirate and quantitative microbiological criterion were used. Out of 226 consecutive patients, 103 patients (46%) had an aspiration syndrome, including 54 (52%) with a BAP. <i>Staphylococcus aureus</i> represented 33% of bacterial strains. No relevant baseline characteristics differed, including serum levels of CRP, PCT, and albumin. The median duration of treatment for BAP was 7 days (5–7). Patients with BAP did not have a longer duration of MV (<i>p</i> = 0.18) and ICU stay (<i>p</i> = 0.18) than those with pneumonitis. At 3 months, 24 patients (44%) with BAP and 10 (27%) with pneumonitis had a poor functional outcome (<i>p</i> = 0.06). In conclusion, among patients with GCSE, half of the patients had an aspiration syndrome and one-quarter suffered from BAP. Clinical characteristics and biomarkers were not useful for differentiating BAP from pneumonitis. These results highlight the need for a method to rapidly differentiate BAP from pneumonitis, such as polymerase-chain-reaction-based techniques.https://www.mdpi.com/2077-0383/11/22/6673status epilepticusintensive care unitbacterial aspiration pneumonia3-month outcome |
| spellingShingle | Romain Tortuyaux Frédéric Wallet Philippe Derambure Saad Nseir Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome Journal of Clinical Medicine status epilepticus intensive care unit bacterial aspiration pneumonia 3-month outcome |
| title | Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome |
| title_full | Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome |
| title_fullStr | Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome |
| title_full_unstemmed | Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome |
| title_short | Bacterial Aspiration Pneumonia in Generalized Convulsive Status Epilepticus: Incidence, Associated Factors and Outcome |
| title_sort | bacterial aspiration pneumonia in generalized convulsive status epilepticus incidence associated factors and outcome |
| topic | status epilepticus intensive care unit bacterial aspiration pneumonia 3-month outcome |
| url | https://www.mdpi.com/2077-0383/11/22/6673 |
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