A prospective comparison of nursing- and healthcare-associated pneumonia (NHCAP) with community-acquired pneumonia (CAP)

Fukuyama, Hajime; Yamashiro, Satoshi; Tamaki, Hisanobu; Kishaba, Tomoo

doi:10.1007/s10156-013-0557-1

Cited by 54 publications

(62 citation statements)

References 32 publications

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“…However, recent studies indicated the presence of these antibiotic-resistant bacteria is not related to the decreased mortality in HCAP and NHCAP patients (Polverino et al 2013;Fukuyama et al 2013). Our results support these reports that antibiotic-resistant bacteria are not pathogenic factors for the development of pneumonia but are reflecting patients' background conditions.…”

Section: Discussionsupporting

confidence: 82%

Improving Physical Activity Ensures the Long-Term Survival of Pneumonia Patients in a Super-Aged Society: A Retrospective Study in an Acute-Care Hospital in Japan

Sato

Okada

Sugawara

et al. 2016

Tohoku J. Exp. Med.

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Pneumonia is the third largest cause of death in Japan. Chest physicians have been struggling to improve the outcome of pneumonia treatment in acute care settings. However, a poor long-term prognosis after pneumonia has not been well recognized. Furthermore, the factors related to the poor prognosis, especially the possible involvement of senescence-related disability, have not been identified. In this study, long-term outcomes after discharge from hospital were retrospectively analyzed to identify factors related to the poor long-term prognosis. Outcomes of 958 pneumonia patients who were discharged from South Miyagi Medical Center (Miyagi, Japan) from June 1, 2008 to March 31, 2014 were determined through patient surveys or medical record reviews on September 26, 2014. Survival curves were constructed and compared according to various factors. Multivariate analysis revealed that all levels of decrease in physical activity, an age of 80 years old or more, the most severe status in Japanese Respiratory Society pneumonia severity grading system, the presence of antibiotic-resistant bacteria, and comorbid malignancy significantly reduced long-term survival. The effects of dementia, neuromuscular disease, heart disease, and nursing care residency on long-term survival were detected only with univariate analysis. Physical activity influenced the acute-phase and the long-term prognosis of pneumonia. This report provides information to assist physicians in giving better suggestions to disabled older patients when choosing pneumonia treatment options. In conclusion, we propose that death related to pneumonia can be prevented in the same way as non-communicable diseases by improving physical activity.

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Section: Discussionsupporting

confidence: 82%

Improving Physical Activity Ensures the Long-Term Survival of Pneumonia Patients in a Super-Aged Society: A Retrospective Study in an Acute-Care Hospital in Japan

Sato

Okada

Sugawara

et al. 2016

Tohoku J. Exp. Med.

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“…A recent study 32 suggested the MDR pathogens did not increase the mortality in patients with NHCAP, therefore, inappropriate overuse of broad-spectrum antibiotics should not be advised. Compared with patients with community-acquired pneumonia, however, those with HCAP were reported as frequently infected by MDR pathogens, 10 and the present data also showed that 13.8% of patients with NHCAP were identified with 33 and the present study showed that ESBL-producing K. pneumoniae and MDR A. baumannii were significantly associated with 30-day mortality.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

et al. 2015

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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 AE 11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8 AE 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 HCO 3 -level, duration of ICU stay, extended spectrum b-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.

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“…Streptococcus pneumoniae is the most common cause of pneumonia among the elderly, with or without healthcare and nursing ( Table 2) [19][20][21][22][23][24][25][26][27][28]. Staphylococcus aureus, Pseudomonas aeruginosa, and enteric gram-negative rods are also important Fig.…”

Section: Causative Pathogens Of Pneumonia In the Elderlymentioning

confidence: 99%

Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia

Teramoto

Yoshida

Hizawa

2015

Respiratory Investigation

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A prospective comparison of nursing- and healthcare-associated pneumonia (NHCAP) with community-acquired pneumonia (CAP)

Cited by 54 publications

References 32 publications

Improving Physical Activity Ensures the Long-Term Survival of Pneumonia Patients in a Super-Aged Society: A Retrospective Study in an Acute-Care Hospital in Japan

Improving Physical Activity Ensures the Long-Term Survival of Pneumonia Patients in a Super-Aged Society: A Retrospective Study in an Acute-Care Hospital in Japan

Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia

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