Microbial aetiology of healthcare associated pneumonia in Spain: a prospective, multicentre, case-control study
| Autor: | Hcap Study investigators, Rosario Menéndez, Jordi Rello, Antonio D. Dorado, Inmaculada Alfageme, J. M. Vallés, Rafael Zalacain, Josep Blanquer, M Angeles Marcos, Catia Cilloniz, Noelia Llevat, Antoni Torres, Felipe Rodríguez, Jordi Almirall, Eva Polverino, Alberto Capelastegui, Luis Molinos, Salvador Bello |
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| Přispěvatelé: | Universitat de Barcelona |
| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Pediatrics medicine.medical_specialty Etiology Pneumònia medicine.disease_cause Risk Factors Streptococcus pneumoniae Medicine Humans Prospective Studies Prospective cohort study Aged Cross Infection business.industry Mortality rate Incidence (epidemiology) Incidence Case-control study Age Factors Pneumonia medicine.disease Antibiotic coverage Anti-Bacterial Agents Community-Acquired Infections Survival Rate Spain Etiologia Case-Control Studies Female business Follow-Up Studies |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname Dipòsit Digital de la UB Universidad de Barcelona |
| ISSN: | 1468-3296 |
| Popis: | Introduction: Healthcare-associated pneumonia (HCAP) is actually considered a subgroup of hospital-acquired pneumonia due to the reported high risk of multidrug-resistant pathogens in the USA. Therefore, current American Thoracic Society/Infectious Diseases Society of America guidelines suggest a nosocomial antibiotic treatment for HCAP. Unfortunately, the scientific evidence supporting this is contradictory. Methods: We conducted a prospective multicentre case-control study in Spain, comparing clinical presentation, outcomes and microbial aetiology of HCAP and community-acquired pneumonia (CAP) patients matched by age (±10 years), gender and period of admission (±10 weeks). Results: 476 patients (238 cases, 238 controls) were recruited for 2 years from June 2008. HCAP cases showed significantly more comorbidities (including dysphagia), higher frequency of previous antibiotic use in the preceding month, higher pneumonia severity score and worse clinical status (Charslon and Barthel scores). While microbial aetiology did not differ between the two groups (HCAP and CAP: Streptococcus pneumoniae: 51% vs 55%; viruses: 22% vs 12%; Legionella: 4% vs 9%; Gram-negative bacilli: 5% vs 4%; Pseudomonas aeruginosa: 4% vs 1%), HCAP patients showed worse mortality rates (1-month: HCAP, 12%; CAP 5%; 1-year: HCAP, 24%; CAP, 9%), length of hospital stay (9 vs 7 days), 1-month treatment failure (5.5% vs 1.5%) and readmission rate (18% vs 11%) (p |
| Databáze: | OpenAIRE |
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