Comparison of clinical characteristics between healthcare-associated pneumonia and community-acquired pneumonia in patients admitted to secondary hospitals

Lee, Jong Hoo; Kim, Yee Hyung

doi:10.1016/j.bjid.2012.06.019

Cited by 15 publications

(5 citation statements)

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“…Some characteristics of nursing home residents in our study, such as a higher number of patients with two or more comorbidities in the group of nursing home residents and a more common use of antibiotics in this group, were similar to the data found in studies by Lee and Sundvall (26, 27). An average NPCR in the group of elderly living in domestic environment in two consecutive years was 0.85%, which also correlates to some studies conducted among the elderly, where NPCR were 0.32% and 5.3%, respectively (28, 12).…”

Section: Discussionsupporting

confidence: 88%

Nasopharyngeal carriage of Streptococcus pneumoniae and serotypes indentified among nursing home residents in comparison to the elderly and patients younger than 65 years living in domestic environment

Kolšek-Šušteršič

Krasnič

Mioč

et al. 2017

Slovenian Journal of Public Health

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IntroductionIn Slovenia, there is little data available on pneumococcal vaccination rates and no data on asymptomatic NPCR and serotypes in the population of nursing home residents in comparison to the elderly living in domestic environment, therefore the goal was to gain these data.MethodsA cross sectional epidemiological study was performed. Nasopharyngeal swabs from 151 nursing home residents, 150 elderly living in domestic environment, and 38 adults less than 65 years old were collected twice (in two consecutive years). The swabs were analysed for pneumococcal identification and serotyping. Patient data were collected from medical files and medical history.ResultsNo statistically significant differences in NPCR were seen between compared groups in two consecutive years. An average NPCR in two consecutive years in nursing home residents was 1.45%, in the elderly living in domestic environment 0.85%, and in adults less than 65 years old 7.05%. Serotypes identified among nursing home residents were 6B and 9N, among the group of elderly living in domestic environment, 6A and among adults less than 65 years old, 35F, 18C and 3. Pneumococcal vaccination rates were low (3.3% in nursing home residents, 6% in the elderly from domestic environment and 0% in the group of adults less than 65 years old).ConclusionsOur data suggests that NPCR and the proportion of people vaccinated with pneumococcal vaccine among the elderly are low. We identified different serotypes in all groups, only one person was a chronic carrier (serotype 35F).

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Section: Discussionsupporting

confidence: 88%

Nasopharyngeal carriage of Streptococcus pneumoniae and serotypes indentified among nursing home residents in comparison to the elderly and patients younger than 65 years living in domestic environment

Kolšek-Šušteršič

Krasnič

Mioč

et al. 2017

Slovenian Journal of Public Health

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“…The short term mortality from pneumonia is well documented and is consistently between 10-11% (5,6). Mortality from pneumonia is typically assessed at 30 days or at discharge from hospital (7,8) and patients who have clinical resolution of their symptoms at this time are classified as having survived the episode (9). …”

Section: Introductionmentioning

confidence: 99%

Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort

et al. 2015

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Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-years, mean 6·1 years, range 0·08-15·2 years). Cox regression models were constructed to examine the all-cause, respiratory and cardiovascular mortality using date of pneumonia onset as baseline with binary pneumonia status as exposure. A total of 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4-9·9] and 5·9 (95% CI 3·5-9·7), respectively (with very few respiratory deaths within the same period) in cases compared to controls after adjusting for age, sex, asthma, smoking status, pack years, systolic and diastolic blood pressure, diabetes, physical activity, waist-to-hip ratio, prevalent cardiovascular and respiratory diseases. All outcomes assessed also showed increased risk of death in cases compared to controls after 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9-30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.

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“…6 ), which is in accordance with a recent systematic review and meta-analysis on the accuracy of HCAP definition to identify potentially resistant pathogens [ 15 ]. The HCAP definition adopted by the authors was the one proposed by ATS/IDSA [ 13 ], but only five of the included studies met that definition [ 24 , 31 , 36 – 38 ]; the additional 19 studies used different definitions (some of them included immunosuppression) [ 7 , 39 ] and the majority [ 10 , 25 , 26 , 40 – 45 ] used the definition proposed by Friedman et al [ 1 ]. The nine studies that used the definition by Friedman et al [ 1 ] were also included in the current review.…”

Section: Discussionmentioning

confidence: 99%

Microbiology of healthcare-associated infections and the definition accuracy to predict infection by potentially drug resistant pathogens: a systematic review

et al. 2015

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BackgroundHealthcare-associated infections (HCAI) represent up to 50 % of all infections among patients admitted from the community. The current review intends to provide a systematic review on the microbiological profile involved in HCAI, to compare it with community-acquired (CAI) and hospital-acquired infections (HAI) and to evaluate the definition accuracy to predict infection by potentially drug resistant pathogens.MethodsWe search for HCAI in MEDLINE, SCOPUS and ISI Web of Knowledge with no limitations in regards to publication language, date of publication, study design or study quality. Only studies using the definition by Friedman et al. were included. This review was registered at PROSPERO Systematic Review Registration with the Number CRD42014013648.ResultsA total of 21 eligible studies with 12,096 infected patients were reviewed; of these 3497 had HCAI, 2723 were microbiologically documented. Twelve studies were on pneumonia involving 1051 patients with microbiological documented HCAI, the application of the current guidelines for this group of patients would result in an appropriate antibiotic therapy in 95 % of cases at the expense of overtreatment in 73 %; the application of community-acquired pneumonia guidelines would be adequate in only 73–76 % of the cases; an alternative regimen with piperacillin-tazobactam or aztreonam plus azithromycin would increase antibiotic adequacy rate to 90 %. Few studies were found on additional focus of infection: endocarditis, urinary, intra-abdominal and bloodstream infections. All studies included in this review showed an association of the HCAI definition with infection by PDR pathogens when compared to CAI [odds ratio (OR) 4.05, 95 % confidence interval (95 % CI) 2.60–6.31)]. The sensitivity of HCAI to predict infection by a PDR pathogen was 0.69 (0.65–0.72), specificity was 0.67 (0.66–0.68), positive likelihood ratio was 1.9 and the area under the summary ROC curve was 0.71.ConclusionsThis systematic review provides evidence that HCAI represents a separate group of infections in terms of the microbiology profile, including a significant association with infection by PDR pathogens, for the main focus of infection. The results provided can help clinician in the selection of empiric antibiotic therapy and international societies in the development of specific treatment recommendations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1304-2) contains supplementary material, which is available to authorized users.

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Comparison of clinical characteristics between healthcare-associated pneumonia and community-acquired pneumonia in patients admitted to secondary hospitals

Cited by 15 publications

References 15 publications

Nasopharyngeal carriage of Streptococcus pneumoniae and serotypes indentified among nursing home residents in comparison to the elderly and patients younger than 65 years living in domestic environment

Nasopharyngeal carriage of Streptococcus pneumoniae and serotypes indentified among nursing home residents in comparison to the elderly and patients younger than 65 years living in domestic environment

Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort

Microbiology of healthcare-associated infections and the definition accuracy to predict infection by potentially drug resistant pathogens: a systematic review

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