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KMID : 0338420220370040800
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The Korean Journal of Internal Medicine
2022 Volume.37 No. 4 p.800 ~ p.810
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Microbiologic pattern and clinical outcome of non-ICU-acquired pneumonia: Korean HAP registry analysis
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Jang Jin-Ho
Yeo Hye-Ju
Kim Tae-Hwa
Cho Woo-Hyun
Min Kyung-Hoon
Hong Sang-Bum
Baek Ae-Rin
Lee Hyun-Kyung
Kim Chang-Hwan
Chang You-Jin
Park Hye-Kyeong
Oh Jee-Youn
Lee Heung-Bum
Bae Soo-Hyun
Moon Jae-Young
Yoo Kwang-Ha
Gil Hyun-Il
Jeon Kyeong-Man
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Abstract
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Background/Aims: Most studies on hospital-acquired pneumonia (HAP) have been conducted in intensive care unit (ICU) settings. This study aimed to investigate the microbiological and clinical characteristics of non-ICU-acquired pneumonia (NIAP) and to identify the factors affecting clinical outcomes in Korea.
Methods: This multicenter retrospective cohort study was conducted in patients admitted to 13 tertiary hospitals between July 1, 2019 and December 31, 2019. Patients diagnosed with NIAP were included in this study. To assess the prognostic factors of NIAP, the study population was classified into treatment success and failure groups.
Results: Of 526 patients with HAP, 379 were diagnosed with NIAP. Overall, the identified causative pathogen rate was 34.6% in the study population. Among the isolated organisms (n = 113), gram-negative bacilli were common pathogens (n = 91), such as Pseudomonas aeruginosa (n = 25), Acinetobacter baumannii (n = 23), and Klebsiella pneumoniae (n = 21). The multidrug resistance rates of A. baumannii, P. aeruginosa, and K. pneumoniae were 91.3%, 76.0%, and 57.1%, respectively. Treatment failure was significantly associated with K. pneumoniae (odds ratio [OR], 3.50; 95% confidence interval [CI], 1.35 to 9.05; p = 0.010), respiratory viruses (OR, 3.81; 95% CI, 1.34 to 10.82; p = 0.012), hematological malignancies (OR, 3.54; 95% CI, 1.57 to 8.00; p = 0.002), and adjunctive corticosteroid treatment (OR, 2.40; 95% CI, 1.27 to 4.52; p = 0.007).
Conclusions: The causative pathogens of NIAP in Korea are predominantly gram-negative bacilli with a high rate of multidrug resistance. These were not different from the common pathogens of ICU-acquired pneumonia.
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KEYWORD
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Healthcare-associated pneumonia, General ward, Microbiology, Prognosis, Korea
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