Non Invasive Ventilation (NIV) is able to reduce in specific populations the risk of reintubation, mortality, length of stay and occurrence of lung infection. However, uncertain results are described in literature in treatment in SARS-CoV2 pneumoniae, moreover Hospital Acquired Pneumoniae (HAP) and sovrainfections in patients undergoing NIV are neglected.
The objective was to evaluate incidence and prevalence of microbiological species in subjects who developed pneumonia following more than 48 h of consecutive NIV, who required subintensive care for their severe respiratory failure due to SARS-COV-2 illness. We recruited retrospectively, from March 2019 to September 2022, a population of 84 subjects in Subintensive Respiratory Unit. 34 patients developed an incoming HAP (40.5 %), with a 30 days mortality of 76.7 %, compared to patients with only ARDS-Sars-COV2 (53.7 %).
All patients underwent detailed medical history and examination, blood tests and routinary microbiological specimens. Microbiological isolates are described in Figure 1, with an unexpected recurrence of Acinetobater baumannii (12 cases, 35.3 %). Patients at risk of developing HAP had received immunosuppressive therapies or prolonged corticosteroid exposure. Ischemic and failure heart disease were the most associated comorbidities.
Meticulous strategies to prevent transmission of multi drug resistant germs are needed, especially during SARS-CoV2 pandemic.