Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia
| Autor: | Suk Joong Yong, Ye Ryung Jung, Jae Ho Seong, Yeun Seoung Choi, Hyeoncheol Park, Myoung Kyu Lee, Kye Chul Shin, Jiwon Choi, Sang-Ha Kim, Won Yeon Lee |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Critical Care Biochemistry law.invention Nursing Healthcare associated law Pneumonia Bacterial medicine Humans In patient Intensive care medicine Aged Retrospective Studies Aged 80 and over Cross Infection Respiratory Care Units business.industry Biochemistry (medical) Cell Biology General Medicine Middle Aged medicine.disease Intensive care unit Anti-Bacterial Agents Klebsiella Infections Pneumonia Treatment Outcome Multivariate Analysis Drug Therapy Combination Female Nursing Care business Acinetobacter Infections |
| Zdroj: | Journal of International Medical Research. 43:236-249 |
| ISSN: | 1473-2300 0300-0605 |
| DOI: | 10.1177/0300060514551188 |
| Popis: | Objective To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results Out of 428 patients reviewed (male, 67.1%; mean age, 71.2 ± 11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8 ± 13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3– level, duration of ICU stay, extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP. |
| Databáze: | OpenAIRE |
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