In:
The Korean Journal of Internal Medicine, Korean Association of Internal Medicine, Vol. 37, No. 4 ( 2022-07-01), p. 800-810
Abstract:
Background/Aims: Most studies on hospital-acquired pneumonia (HAP) have been conducted in intensive care unit (ICU) settings. This study aimed to investigate the microbiological and clinical characteristics of non-ICU-acquired pneumonia (NIAP) and to identify the factors affecting clinical outcomes in Korea.Methods: This multicenter retrospective cohort study was conducted in patients admitted to 13 tertiary hospitals between July 1, 2019 and December 31, 2019. Patients diagnosed with NIAP were included in this study. To assess the prognostic factors of NIAP, the study population was classified into treatment success and failure groups.Results: Of 526 patients with HAP, 379 were diagnosed with NIAP. Overall, the identified causative pathogen rate was 34.6% in the study population. Among the isolated organisms (n = 113), gram-negative bacilli were common pathogens (n = 91), such as 〈 i 〉 Pseudomonas aeruginosa 〈 /i 〉 (n = 25), 〈 i 〉 Acinetobacter baumannii 〈 /i 〉 (n = 23), and 〈 i 〉 Klebsiella pneumoniae 〈 /i 〉 (n = 21). The multidrug resistance rates of 〈 i 〉 A. baumannii 〈 /i 〉 , 〈 i 〉 P. aeruginosa 〈 /i 〉 , and 〈 i 〉 K. pneumoniae 〈 /i 〉 were 91.3%, 76.0%, and 57.1%, respectively. Treatment failure was significantly associated with 〈 i 〉 K. pneumoniae 〈 /i 〉 (odds ratio [OR], 3.50; 95% confidence interval [CI] , 1.35 to 9.05; 〈 i 〉 p 〈 /i 〉 = 0.010), respiratory viruses (OR, 3.81; 95% CI, 1.34 to 10.82; 〈 i 〉 p 〈 /i 〉 = 0.012), hematological malignancies (OR, 3.54; 95% CI, 1.57 to 8.00; 〈 i 〉 p 〈 /i 〉 = 0.002), and adjunctive corticosteroid treatment (OR, 2.40; 95% CI, 1.27 to 4.52; 〈 i 〉 p 〈 /i 〉 = 0.007).Conclusions: The causative pathogens of NIAP in Korea are predominantly gram-negative bacilli with a high rate of multidrug resistance. These were not different from the common pathogens of ICU-acquired pneumonia.
Type of Medium:
Online Resource
ISSN:
1226-3303
,
2005-6648
DOI:
10.3904/kjim.2021.348
Language:
English
Publisher:
Korean Association of Internal Medicine
Publication Date:
2022
detail.hit.zdb_id:
2500508-X
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