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1/# Excited to share our #NUCOVIDInvestigators work looking at #BAL in intubated #COVID19 patients with @NM_lung @RoganAGrant @MichaelCuttica @luisamnMD @nufeinbergmed @NU_IntMed
@BavishiAvni @jarnold93 @ScottBudinger @bsinger007 & Rich Wunderink! https://www.medrxiv.org/content/10.1101/2021.01.12.20248588v1
@BavishiAvni @jarnold93 @ScottBudinger @bsinger007 & Rich Wunderink! https://www.medrxiv.org/content/10.1101/2021.01.12.20248588v1
2/# We looked at 179 ventilated patients with #SARSCoV2; 91% had BAL within 48hrs of intubation, and a bacterial superinfection (by culture or @BiofireDX PCR) was found in 21% - mostly wimpy CAP bugs like Staph or Strep despite patients meeting HAP definition. Demographics:
3/# Neither clinical features (fever) nor biomarkers nor even BAL cell count helped significantly distinguish between just COVID vs COVID+bacterial superinfection. Early bacterial superinfection was associated with longer ventilation and more trachs, but not higher mortality.
4/# Clinicians quickly narrowed antibiotics in response to BAL results. Results of bronchoscopy allowed clinicians to administer more narrow antibiotics than would be recommended by CAP guidelines (zero in these graphs).
5/# 44% of patients had at least one VAP; incidence rate of 45/1000 days of ventilation. Many VAPs remained sensitive to narrow-spectrum antibiotics.
6/# I had a great time and learned so much working on this with everyone! Onwards to the next project!
