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Publications

Journal Article Ahead of print 1 citation

PubMed: 41593756 DOI: 10.1186/s44158-026-00349-z

The SIS NET ICU study: characteristics of patients with severe community acquired pneumonia admitted to Italian ICUs-a multicenter prospective observational study.

J Anesth Analg Crit Care

Authors: Mariachiara Ippolito, Giulia Catalisano, Matteo Velardo, Marina Campione, Michael Damiano, Maria Grazia Bocci, Barbara Camilloni, Clementina Cocuzza, Manola Comar, Edoardo De Robertis, Teresa Maria Assunta Fasciana, Roberto Fumagalli, Giovanni Maurizio Giammanco, Massimo Girardis, Anna Marchese, Ettore Panascia, Maria Caterina Pace, Cesira Palmeri di Villalba, Nicolò Patroniti, Erik Roman-Pugnuz, Santi Maurizio Raineri, Stefano Romagnoli, Savino Spadaro, Pierpaolo Terragni, Sergio Uzzau, Rosanna Vaschetto, Andrea Cortegiani, Antonino Giarratano

Affiliations

  • Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C), University of Palermo, Palermo, 90127, Italy.
  • Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo, 90127, Italy.
  • Intensive Care Unit and Anesthesiology, National Institute for Infectious Diseases IRCCS, Rome, Italy.
  • Dipartimento Medicina E Chirurgia-Università Degli Studi Di Perugia-Azienda Ospedaliera Di Perugia, Perugia, Italy.
  • Laboratorio Di Microbiologia E Virologia Clinica, Dipartimento Medicina E Chirurgia, Università Di Milano-Bicocca, Milan, Italy.
  • Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.
  • SC Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, Trieste, Italy.
  • Dipartimento Promozione Della Salute, Materno-Infantile, Di Medicina Interna E Specialistica Di Eccellenza "G. D'Alessandro" (PROMISE), Universita' Di Palermo, Palermo, Italy.
  • Servizio di Anestesia e Rianimazione 1, Grande Ospedale Metropolitano Niguarda, Milano, Dipartimento Medicina E Chirurgia, Università Di Milano-Bicocca, Milan, Italy.
  • Anaesthesia and ICU Department, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Dipartimento DISC, Sezione Di Microbiologia, Università Degli Studi Di Genova, Genoa, Italy.
  • IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  • Dipartimento dell'Emergenza Urgenza Azienda Universitaria Policlinico San Marco Catania, Divisione Anestesia e Rianimazione III, Catania, Italy.
  • Dipartimento Della Donna, del bambino e Di Chirurgia Generale E Specialistica, Università Della Campania "Luigi Vanvitelli", Caserta, Italy.
  • Dipartimento Di Scienze Chirurgiche Diagnostiche Ed Integrate, University of Genoa, Genoa, 16126, Italy.
  • Department of Health Science, Section of Anesthesia and Intensive Care, University of Florence, Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
  • Dipartimento Di Medicina, Traslazionale Università Degli Studi Di Ferrara, Ferrara, Italy.
  • Dipartimento Di Medicina d'emergenza-Urgenza Azienda Ospedaliera, Universitaria Di Ferrara, Ferrara, Italy.
  • Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
  • Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
  • Dipartimento Di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy.
  • Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C), University of Palermo, Palermo, 90127, Italy.
  • Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo, 90127, Italy.

Abstract

BACKGROUND

The SIS-NET ICU study aimed to describe the epidemiology of severe community-acquired pneumonia (CAP) among patients admitted to Italian intensive care units (ICUs). This study also aimed to describe the clinical and microbiological characteristics, outcomes, and treatments received by the included patients.

METHODS

We conducted a prospective, observational, multicenter study. We included patients consecutively admitted to the ICUs of 13 participating centers during the study period for acute respiratory failure due to CAP. The study period spanned from January to November 2025. The analyses aimed to describe the epidemiological and clinical characteristics, diagnostic pathways, factors associated with ICU mortality, and type of respiratory support during the ICU stay.

RESULTS

We included a cohort of 150 patients with a mean age of 63 years and a male predominance (61%). The occurrence rate of CAP in the participating ICUs was 2.5%. Streptococcus pneumoniae, Haemophilus influenzae, Influenza A and Respiratory Syncytial Virus were the predominant isolated microorganisms. The average APACHE II score was 17 (SD 7.9) and the median SOFA score was 7 (SD 3.9). The comorbidity burden was substantial. A high proportion of patients was managed with non-invasive respiratory supports. Rapid microbiological testing methods were early adopted in 63% of patients, with substantial impact on antimicrobial therapy decisions. Each 10-year increase in age was associated with a 54% increase in the odds of death (aOR 1.54, 95% CI 1.06-2.35; p = 0.02) and immunosuppressed status was associated with higher odds of death (aOR 3.13, 95% CI 1.04-9.63; p = 0.04). Polymicrobial infection showed a trend towards higher mortality (aOR 2.47, 95% CI 0.94-6.89; p = 0.06), although this association did not reach conventional statistical significance.

CONCLUSIONS

Our study demonstrated the predominance of common pathogens as microbiological isolates in patients with severe CAP in Italy. Age, and immunosuppressed status were independently associated with a higher odds of mortality.

MeSH

Mortality, Pneumonia, Therapeutics, Intensive Care Units, Community-Acquired Pneumonia