Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study.
To access publisher's full text version of this article click on the hyperlink at the bottom of the page The classification of pneumonia as community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) has implications for selection of initial antimicrobial therapy. HCAP has been...
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Online Access: | http://hdl.handle.net/2336/567022 https://doi.org/10.3109/00365548.2014.980842 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/567022 2023-05-15T16:51:49+02:00 Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. Bjarnason, Agnar Asgeirsson, Hilmir Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus 1 Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland 2 Sahlgrens Univ Hosp, Dept Infect Dis, Gothenburg, Sweden 3 Landspitali Univ Hosp, Dept Med, Reykjavik, Iceland 4 Landspitali Univ Hosp, Dept Clin Microbiol, Reykjavik, Iceland 2015 http://hdl.handle.net/2336/567022 https://doi.org/10.3109/00365548.2014.980842 en eng Informa Healthcare http://dx.doi.org/ 10.3109/00365548.2014.980842 http://informahealthcare.com/doi/pdf/10.3109/00365548.2014.980842 Infect Dis (Lond) 2015, 47 (3):130-6 2374-4243 25664503 doi:10.3109/00365548.2014.980842 http://hdl.handle.net/2336/567022 Infectious diseases (London, England) Archived with thanks to Infectious diseases (London, England) National Consortium - Landsaðgangur Lungnabólga Pneumonia Drug Resistance Microbial Pneumonia/etiology Pneumonia/mortality Article 2015 ftlandspitaliuni https://doi.org/10.3109/00365548.2014.980842 2022-05-29T08:22:06Z To access publisher's full text version of this article click on the hyperlink at the bottom of the page The classification of pneumonia as community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) has implications for selection of initial antimicrobial therapy. HCAP has been associated with an increased prevalence of multidrug-resistant (MDR) pathogens and with high mortality leading to recommendations for broad empiric therapy. We performed a prospective, population-based study on consecutive adults (≥ 18 years) admitted for pneumonia over 1 calendar year. Patients were classified by pneumonia type and severity. Microbial etiologic testing was performed on all patients. Treatment, length of stay, and mortality rates were compared. A total of 373 admissions were included, 94% of all eligible patients. They were classified as CAP (n = 236, 63%) or HCAP (n = 137, 37%). Chronic underlying disease was more commonly found among patients with HCAP compared with CAP (74% vs 51%, p < 0.001). Mycoplasma pneumoniae was more common among CAP patients (p < 0.01), while gram-negative bacteria were more often found among HCAP patients (p = 0.02). No MDR pathogens were detected, and rates of Staphylococcus aureus were similar in the two groups. HCAP patients were not more likely to receive ineffective initial antimicrobial therapy. HCAP patients had worse prognostic scores on admission and higher in-house mortality than CAP patients (10% vs 1%, respectively, p < 0.01). Even in a low resistance setting, patients with HCAP have increased mortality compared with patients with CAP. This is most likely explained by a higher prevalence of co-morbidities. Our data do not support broad-spectrum empiric antibiotic therapy for HCAP. Icelandic Center for Research, Rannis 100436021 Landspitali University Hospital Science Fund University of Iceland Research Fund Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Infectious Diseases 47 3 130 136 |
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Hirsla - Landspítali University Hospital research archive |
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ftlandspitaliuni |
language |
English |
topic |
Lungnabólga Pneumonia Drug Resistance Microbial Pneumonia/etiology Pneumonia/mortality |
spellingShingle |
Lungnabólga Pneumonia Drug Resistance Microbial Pneumonia/etiology Pneumonia/mortality Bjarnason, Agnar Asgeirsson, Hilmir Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
topic_facet |
Lungnabólga Pneumonia Drug Resistance Microbial Pneumonia/etiology Pneumonia/mortality |
description |
To access publisher's full text version of this article click on the hyperlink at the bottom of the page The classification of pneumonia as community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) has implications for selection of initial antimicrobial therapy. HCAP has been associated with an increased prevalence of multidrug-resistant (MDR) pathogens and with high mortality leading to recommendations for broad empiric therapy. We performed a prospective, population-based study on consecutive adults (≥ 18 years) admitted for pneumonia over 1 calendar year. Patients were classified by pneumonia type and severity. Microbial etiologic testing was performed on all patients. Treatment, length of stay, and mortality rates were compared. A total of 373 admissions were included, 94% of all eligible patients. They were classified as CAP (n = 236, 63%) or HCAP (n = 137, 37%). Chronic underlying disease was more commonly found among patients with HCAP compared with CAP (74% vs 51%, p < 0.001). Mycoplasma pneumoniae was more common among CAP patients (p < 0.01), while gram-negative bacteria were more often found among HCAP patients (p = 0.02). No MDR pathogens were detected, and rates of Staphylococcus aureus were similar in the two groups. HCAP patients were not more likely to receive ineffective initial antimicrobial therapy. HCAP patients had worse prognostic scores on admission and higher in-house mortality than CAP patients (10% vs 1%, respectively, p < 0.01). Even in a low resistance setting, patients with HCAP have increased mortality compared with patients with CAP. This is most likely explained by a higher prevalence of co-morbidities. Our data do not support broad-spectrum empiric antibiotic therapy for HCAP. Icelandic Center for Research, Rannis 100436021 Landspitali University Hospital Science Fund University of Iceland Research Fund |
author2 |
1 Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland 2 Sahlgrens Univ Hosp, Dept Infect Dis, Gothenburg, Sweden 3 Landspitali Univ Hosp, Dept Med, Reykjavik, Iceland 4 Landspitali Univ Hosp, Dept Clin Microbiol, Reykjavik, Iceland |
format |
Article in Journal/Newspaper |
author |
Bjarnason, Agnar Asgeirsson, Hilmir Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus |
author_facet |
Bjarnason, Agnar Asgeirsson, Hilmir Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus |
author_sort |
Bjarnason, Agnar |
title |
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
title_short |
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
title_full |
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
title_fullStr |
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
title_full_unstemmed |
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
title_sort |
mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study. |
publisher |
Informa Healthcare |
publishDate |
2015 |
url |
http://hdl.handle.net/2336/567022 https://doi.org/10.3109/00365548.2014.980842 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://dx.doi.org/ 10.3109/00365548.2014.980842 http://informahealthcare.com/doi/pdf/10.3109/00365548.2014.980842 Infect Dis (Lond) 2015, 47 (3):130-6 2374-4243 25664503 doi:10.3109/00365548.2014.980842 http://hdl.handle.net/2336/567022 Infectious diseases (London, England) |
op_rights |
Archived with thanks to Infectious diseases (London, England) National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.3109/00365548.2014.980842 |
container_title |
Infectious Diseases |
container_volume |
47 |
container_issue |
3 |
container_start_page |
130 |
op_container_end_page |
136 |
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1766041929066217472 |