The clinical and microbial characteristics of healthcare-associated pneumonia

Won Kyung Yoon,; Min Kim,; Yi Young Kim,; Yun Ji Lee,; Yup Hwangbo,; Keum Ju Choi,; Jun Hyun Hwang,; Seung Wook Jung,; Seung Soo Yoo,; Shin Yup Lee,; Seung Ick Cha,; Jae Yong Park,; Tae Hoon Jung,; Chang Ho Kim,

Korean J Med > Volume 78(6); 2010 > Article

Original Article

The Korean Journal of Medicine 2010;78(6):709-716.

The clinical and microbial characteristics of healthcare-associated pneumonia

Won Kyung Yoon, Min Kim, Yi Young Kim, Yun Ji Lee, Yup Hwangbo, Keum Ju Choi, Jun Hyun Hwang, Seung Wook Jung, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Tae Hoon Jung, Chang Ho Kim

부산대학교 의학전문대학원 내과학교실

의료시설폐렴의 임상적 및 세균학적 특성

윤원경, 김 민, 김이영, 이윤지, 황보엽, 최금주, 황준현, 정승욱, 유승수, 이신엽, 차승익, 박재용, 정태훈, 김창호

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea

Abstract

Background/Aims: Healthcare-associated pneumonia (HCAP) occurs outside hospitals, but its characteristics are similar to those of hospital-acquired pneumonia (HAP). We evaluated the clinical and microbial characteristics of HCAP in Korea. Methods: Of 130 subjects with suspected pneumonia, 49 were classified as HCAP and 81 as HAP. We retrospectively examined the clinical presentations, outcomes, pathogens, and drug resistance rates of Pseudomonas aeruginosae in both groups. Results: The clinical presentations, including the symptoms and laboratory findings, at the time of hospitalization were comparable in both groups. The hospital mortalities of HCAP (28.6%) and HAP (34.6%) did not differ significantly; the length of the hospital stay was similar for all of the survivors (14 vs. 17 days, respectively). Of the identified pathogens, methicillin-resistant Staphylococcus aureus was significantly less common in HCAP than in HAP (two vs. 18 cases, respectively, p<0.01), whereas Klebsiella pneumoniae was more common in HCAP (five vs. zero cases, respectively, p<0.01). The frequency of other Gram-negative rods was similar in both groups. The rate of resistance to antibiotics in P. aeruginosae in both groups was substantial, with the highest resistant rate to ciprofloxacin (50% and 61.5% in HCAP and HAP, respectively). Conclusions: Although the clinical features and outcomes of HCAP were comparable to those of HAP in the study population, the frequency of methicillin-resistant S. aureus was significantly lower in HCAP compared to HAP. (Korean J Med 78:709-716, 2010)

Key Words: Healthcare-associated pneumonia; Hospital-acquired pneumonia