Additional file 2: Table S2. of Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials

Multivariate Cox regression analysis for factors on day 1 including plateau pressure associated with ARDS mortality at day 90. (DOC 33 kb

Serologic Prevalence of Amoeba-Associated Microorganisms in Intensive Care Unit Pneumonia Patients

<div><p>Background</p><p>Patients admitted to intensive care units are frequently exposed to pathogenic microorganisms present in their environment. Exposure to these microbes may lead to the development of hospital-acquired infections that complicate the illness and may be fatal. Amoeba-associated microorganisms (AAMs) are frequently isolated from hospital water networks and are reported to be associated to cases of community and hospital-acquired pneumonia.</p> <p>Methodology/Principal Findings</p><p>We used a multiplexed immunofluorescence assay to test for the presence of antibodies against AAMs in sera of intensive care unit (ICU) pneumonia patients and compared to patients at the admission to the ICU (controls). Our results show that some AAMs may be more frequently detected in patients who had hospital-acquired pneumonia than in controls, whereas other AAMs are ubiquitously detected. However, ICU patients seem to exhibit increasing immune response to AAMs when the ICU stay is prolonged. Moreover, concomitant antibodies responses against seven different microorganisms (5 <i>Rhizobiales</i>, <i>Balneatrix alpica</i>, and Mimivirus) were observed in the serum of patients that had a prolonged ICU stay.</p> <p>Conclusions/Significance</p><p>Our work partially confirms the results of previous studies, which show that ICU patients would be exposed to water amoeba-associated microorganisms, and provides information about the magnitude of AAM infection in ICU patients, especially patients that have a prolonged ICU stay. However, the incidence of this exposure on the development of pneumonia remains to assess.</p> </div

The association between a prolonged ICU stay and exposure to amoeba-associated microorganisms.

<p>The blue period corresponds to the period where a majority of the hospital-acquired pneumonia episodes (>95%) occurred. The CAP episodes mainly occurred from 12 to 24 hours after admission (green period). d; day.</p

Prevalence of antibodies to amoeba-associated microorganisms in pneumonia and in control (admission) sera.

<p>ND; not determined. The asterisk (*) indicates a statistically significant frequency.</p

Hierarchical cluster analysis of patient antibody response to amoeba-associated microorganisms.

<p>This evaluation helped us to identify clusters of microorganisms that are specific to each patient group. To perform this analysis, T-Mev software was used. In the software, number “3” was attributed to positive sera and represented by red color. Number “−3” was attributed to negative sera and represented by green color. Number “2” was attributed to the low-positive sera and represented by dark red sera color. The main cluster detected is shown in yellow. It includes <i>Afipia</i> genospecies 3, <i>M. amorphae, A. felis</i> genospecies A, <i>N. oligomobilis,</i> Mimivirus, <i>B. alpica</i> and <i>B. massiliensis</i>. (AS, admission sera; WS, weekly sera; VAP, ventilator-associated pneumonia sera; CAP, community-acquired pneumonia sera; ASP, Aspiration pneumonia sera; NP, Non ventilator ICU pneumonia sera).</p

Prevalence of antibodies to amoeba-associated microorganisms in acute phase sera from patients with various types of pneumonia.

<p>VAP, ventilator-associated pneumonia; CAP, community-acquired pneumonia; AP, Aspiration pneumonia and NV-ICU-P, Non ventilator ICU-acquired pneumonia, ND; not determined.</p

Seroconversion rates to amoeba-associated microorganisms.

<p>CAP, community-acquired pneumonia; HAP, Hospital-acquired pneumonia; ND; not determined.</p

Prevalence of antibodies to amoeba-associated microorganisms in convalescent-phase sera after hospital-acquired pneumonia and in control (admission) sera.

<p>ND; not determined.</p

Probability of survival in ARDS patients according to the bilirubin level at inclusion.

<p>*: p <0.001 (comparisons between each strata of serum bilirubin level, bilirubin < 20 μmol/L was used as the reference curve).</p

Microorganisms responsible for CAP.

<p>Microorganisms responsible for CAP.</p