{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:04:14Z","timestamp":1787871854615,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ventilator\u2010associated pneumonia (VAP) may be a particular concern in patients with severe coronavirus disease 2019 (COVID\u201019). We aimed to determine the prevalence and etiology of VAP in critically ill COVID\u201019 patients in a Danish intensive care unit (ICU) during the first three waves of the COVID\u201019 pandemic and to study associations between dexamethasone (DXM) use and development of VAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In an observational single\u2010center study patients were retrospectively screened for VAP including causative pathogens, use of DXM and commonly used antibiotics. Diagnosis of VAP required invasive mechanical ventilation (IMV) &gt;48\u2009h with presence of a new bacterial agent and clinical signs of infection. For analysis, common descriptive statistics were applied. Cox proportional hazards models were used to analyze the association between DXM use and VAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VAP was detected in 53\/119 (44.5%) mechanically ventilated patients across all three COVID\u201019 waves. Median length of IMV for VAP patients was 24 [15\u201341] days, and 3 out of 4 were males. VAP was most prevalent (47.0%) during the second wave. Common pathogens included <jats:italic>Klebsiella pneumoniae<\/jats:italic> (24.5%), <jats:italic>Enterobacter aerogenes<\/jats:italic> (17.0%) and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (13.2%), <jats:italic>Staphylococcus aureus<\/jats:italic> (13.2%), <jats:italic>and Escherichia coli<\/jats:italic> (13.2%). A change from Gram\u2010negative bacteria only to a combination of Gram\u2010positive and Gram\u2010negative bacteria was observed in the second wave compared to first. Use of DXM was not associated with VAP (adjusted hazard ratio 1.63 95% CI: 0.84\u20133.17).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of VAP was high across all three COVID\u201019 waves and showed a different distribution of pathogens between the first and second wave. Use of DXM was not associated with VAP development. Further and larger studies are needed to understand the risk factors associated with VAP in patients with COVID\u201019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14523","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T06:50:15Z","timestamp":1727160615000},"page":"1409-1416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and etiology of ventilator\u2010associated pneumonia during the COVID\u201019 pandemic in Denmark: Wave\u2010dependent lessons learned from a mixed\u2010ICU"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5583-4458","authenticated-orcid":false,"given":"Joanna","family":"Grzywacz","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Copenhagen University Hospital \u2013 Amager and Hvidovre Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-3959","authenticated-orcid":false,"given":"Magnus G.","family":"Ahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Copenhagen University Hospital \u2013 Amager and Hvidovre Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0698-9385","authenticated-orcid":false,"given":"Thomas","family":"Benfield","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Copenhagen University Hospital \u2013Amager and Hvidovre Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-9506","authenticated-orcid":false,"given":"Ronan M. G.","family":"Berg","sequence":"additional","affiliation":[{"name":"Centre for Physical Activity Research (CFAS) Copenhagen University Hospital \u2013Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital \u2013Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Biomedical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6658-4833","authenticated-orcid":false,"given":"Ronni R.","family":"Plovsing","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Copenhagen University Hospital \u2013 Amager and Hvidovre Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8960-7524","authenticated-orcid":false,"given":"Andreas","family":"Ronit","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Copenhagen University Hospital \u2013Amager and Hvidovre Hospital  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Statens Serum Institut. 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