{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:30:47Z","timestamp":1784100647659,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","award":["978201"],"award-info":[{"award-number":["978201"]}],"id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016670","name":"Region \u00d6sterg\u00f6tland","doi-asserted-by":"publisher","award":["968674"],"award-info":[{"award-number":["968674"]}],"id":[{"id":"10.13039\/100016670","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ventilator\u2010associated lower respiratory tract infections (VA\u2010LRTI) increase morbidity and mortality in intensive care unit (ICU) patients. Higher incidences of VA\u2010LRTI have been reported among COVID\u201019 patients requiring invasive mechanical ventilation (IMV). The primary objectives of this study were to describe clinical characteristics, incidence, and risk factors comparing patients who developed VA\u2010LRTI to patients who did not, in a cohort of Swedish ICU patients with acute hypoxemic respiratory failure due to COVID\u201019. Secondary objectives were to decipher changes over the three initial pandemic waves, common microbiology and the effect of VA\u2010LTRI on morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter, retrospective cohort study of all patients admitted to 10 ICUs in southeast Sweden between March 1, 2020 and May 31, 2021 because of acute hypoxemic respiratory failure due to COVID\u201019 and were mechanically ventilated for at least 48\u2009h. The primary outcome was culture verified VA\u2010LRTI. Patient characteristics, ICU management, clinical course, treatments, microbiological findings, and mortality were registered. Logistic regression analysis was conducted to determine risk factors for first VA\u2010LRTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of a total of 536 included patients, 153 (28.5%) developed VA\u2010LRTI. Incidence rate of first VA\u2010LRTI was 20.8 per 1000\u2009days of IMV. Comparing patients with VA\u2010LRTI to those without, no differences in mortality, age, sex, or number of comorbidities were found. Patients with VA\u2010LRTI had fewer ventilator\u2010free days, longer ICU stay, were more frequently ventilated in prone position, received corticosteroids more often and were more frequently on antibiotics at intubation. Regression analysis revealed increased adjusted odds\u2010ratio (aOR) for first VA\u2010LRTI in patients treated with corticosteroids (aOR 2.64 [95% confidence interval [CI]] [1.31\u20135.74]), antibiotics at intubation (aOR 2.01 95% CI [1.14\u20133.66]), and days of IMV (aOR 1.05 per day of IMV, 95% CI [1.03\u20131.07]). Few multidrug\u2010resistant pathogens were identified. Incidence of VA\u2010LRTI increased from 14.5 per 1000\u2009days of IMV during the first wave to 24.8 per 1000\u2009days of IMV during the subsequent waves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report a high incidence of culture\u2010verified VA\u2010LRTI in a cohort of critically ill COVID\u201019 patients from the first three pandemic waves. VA\u2010LRTI was associated with increased morbidity but not 30\u2010, 60\u2010, or 90\u2010day mortality. Corticosteroid treatment, antibiotics at intubation and time on IMV were associated with increased aOR of first VA\u2010LRTI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14338","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T01:18:40Z","timestamp":1695777520000},"page":"226-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk factors for ventilator\u2010associated lower respiratory tract infection in <scp>COVID<\/scp>\u201019, a retrospective multicenter cohort study in Sweden"],"prefix":"10.1111","volume":"68","author":[{"given":"Gustaf","family":"Forsberg","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Link\u00f6ping University Hospital  Link\u00f6ping Sweden"},{"name":"Department of Health, Medicine and Caring Sciences Link\u00f6ping University  Link\u00f6ping 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