{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:37:11Z","timestamp":1793893031391,"version":"4.8.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2011,2,16]],"date-time":"2011-02-16T00:00:00Z","timestamp":1297814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,2,16]],"date-time":"2011-02-16T00:00:00Z","timestamp":1297814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Since positive blood cultures are uncommon in patients with nosocomial pneumonia (NP), the responsible pathogens are usually isolated from respiratory samples. Studies on bacteremia associated with hospital-acquired pneumonia (HAP) have reported fatality rates of up to 50%. The purpose of the study is to compare risk factors, pathogens and outcomes between bacteremic nosocomial pneumonia (B-NP) and nonbacteremic nosocomial pneumonia (NB-NP) episodes.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>This is a prospective, observational and multicenter study (27 intensive care units in nine European countries). Consecutive patients requiring invasive mechanical ventilation for an admission diagnosis of pneumonia or on mechanical ventilation for &gt; 48 hours irrespective of admission diagnosis were recruited.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>A total of 2,436 patients were evaluated; 689 intubated patients presented with NP, 224 of them developed HAP and 465 developed ventilation-acquired pneumonia. Blood samples were extracted in 479 (69.5%) patients, 70 (14.6%) being positive. B-NP patients had higher Simplified Acute Physiology Score (SAPS) II score (51.5 \u00b1 19.8 vs. 46.6 \u00b1 17.5, <jats:italic>P<\/jats:italic> = 0.03) and were more frequently medical patients (77.1% vs. 60.4%, <jats:italic>P<\/jats:italic> = 0.01). Mortality in the intensive care unit was higher in B-NP patients compared with NB-NP patients (57.1% vs. 33%, <jats:italic>P<\/jats:italic> &lt; 0.001). B-NP patients had a more prolonged mean intensive care unit length of stay after pneumonia onset than NB-NP patients (28.5 \u00b1 30.6 vs. 20.5 \u00b1 17.1 days, <jats:italic>P<\/jats:italic> = 0.03). Logistic regression analysis confirmed that medical patients (odds ratio (OR) = 5.72, 95% confidence interval (CI) = 1.93 to 16.99, <jats:italic>P<\/jats:italic> = 0.002), methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) etiology (OR = 3.42, 95% CI = 1.57 to 5.81, <jats:italic>P<\/jats:italic> = 0.01), <jats:italic>Acinetobacter baumannii<\/jats:italic> etiology (OR = 4.78, 95% CI = 2.46 to 9.29, <jats:italic>P<\/jats:italic> &lt; 0.001) and days of mechanical ventilation (OR = 1.02, 95% CI = 1.01 to 1.03, <jats:italic>P<\/jats:italic> &lt; 0.001) were independently associated with B-NP episodes. Bacteremia (OR = 2.01, 95% CI = 1.22 to 3.55, <jats:italic>P<\/jats:italic> = 0.008), diagnostic category (medical patients (OR = 3.71, 95% CI = 2.01 to 6.95, <jats:italic>P<\/jats:italic> = 0.02) and surgical patients (OR = 2.32, 95% CI = 1.10 to 4.97, <jats:italic>P<\/jats:italic> = 0.03)) and higher SAPS II score (OR = 1.02, 95% CI = 1.01 to 1.03, <jats:italic>P<\/jats:italic> = 0.008) were independent risk factors for mortality.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>B-NP episodes are more frequent in patients with medical admission, MRSA and <jats:italic>A. baumannii<\/jats:italic> etiology and prolonged mechanical ventilation, and are independently associated with higher mortality rates.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc10036","type":"journal-article","created":{"date-parts":[[2011,2,16]],"date-time":"2011-02-16T20:11:17Z","timestamp":1297887077000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["Bacteremia is an independent risk factor for mortality in nosocomial pneumonia: a prospective and observational multicenter study"],"prefix":"10.1186","volume":"15","author":[{"given":"M\u00f2nica","family":"Magret","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago","family":"Lisboa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Martin-Loeches","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"M\u00e1\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Nauwynck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Wrigge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvano","family":"Cardellino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emili","family":"D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despina","family":"Koulenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Rello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EU-VAP\/CAP Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,2,16]]},"reference":[{"key":"9327_CR1","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1183\/09031936.93.04081020","volume":"4","author":"J Rello","year":"1991","unstructured":"Rello J, Mirelis B, Alonso C, Prats G: Lack of usefulness of blood cultures to diagnose ventilator-associated pneumonia. 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