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10-01-2024 | Pneumonia | Narrative Review

ICU-acquired infections in immunocompromised patients

Authors: Louis Kreitmann, Julie Helms, Ignacio Martin-Loeches, Jorge Salluh, Garyphallia Poulakou, Frédéric Pène, Saad Nseir

Published in: Intensive Care Medicine | Issue 3/2024

Abstract

Immunocompromised patients account for an increasing proportion of the typical intensive care unit (ICU) case-mix. Because of the increased availability of new drugs for cancer and auto-immune diseases, and improvement in the care of the most severely immunocompromised ICU patients (including those with hematologic malignancies), critically ill immunocompromised patients form a highly heterogeneous patient population. Furthermore, a large number of ICU patients with no apparent immunosuppression also harbor underlying conditions altering their immune response, or develop ICU-acquired immune deficiencies as a result of sepsis, trauma or major surgery. While infections are associated with significant morbidity and mortality in immunocompromised critically ill patients, little specific data are available on the incidence, microbiology, management and outcomes of ICU-acquired infections in this population. As a result, immunocompromised patients are usually excluded from trials and guidelines on the management of ICU-acquired infections. The most common ICU-acquired infections in immunocompromised patients are ventilator-associated lower respiratory tract infections (which include ventilator-associated pneumonia and tracheobronchitis) and bloodstream infections. Recently, several large observational studies have shed light on some of the epidemiological specificities of these infections—as well as on the dynamics of colonization and infection with multidrug-resistant bacteria—in these patients, and these will be discussed in this review. Immunocompromised patients are also at higher risk than non-immunocompromised hosts of fungal and viral infections, and the diagnostic and therapeutic management of these infections will be covered. Finally, we will suggest some important areas of future investigation.

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Title: ICU-acquired infections in immunocompromised patients
Authors: Louis Kreitmann
Julie Helms
Ignacio Martin-Loeches
Jorge Salluh
Garyphallia Poulakou
Frédéric Pène
Saad Nseir
Publication date: 10-01-2024
Publisher: Springer Berlin Heidelberg
Keyword: Pneumonia
Published in: Intensive Care Medicine / Issue 3/2024
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-023-07295-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ICU-acquired infections in immunocompromised patients

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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