RT Journal Article
SR Electronic
T1 Risk factors, etiology and prognosis of adult patients with hospital -acquired pneumonia in Shanghai
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2492
VO 40
IS Suppl 56
A1 Ning Li
A1 Qijian Cheng
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2492.abstract
AB Objective To investigate clinical features, risk factors, drug resistance, and clinical outcomes of hospital-acquired pneumonia (HAP) in Shanghai. Methods From November 2007 to December 2009, HAP was observed and prospectively studied in Shanghai seven large general hospitals. Clinical data and etiology of pneumonia were recorded. Blood and sputum cultures, identification of bacteria in specimen and drug sensitivity test were performed. Results We included 204 patients (mean age 68.07 ± 16.61 years [± SD], 58.3% more than 70 years old) mainly from surgical wards, surgical ICU, medical wards, and medical ICU. Patients were complicated with cerebral vascular disease (19.61%), diabetes mellitus (14.22%), or abdominal surgery (11.76%). Ventilator-associated pneumonia occurred in 20.6% of the cases. Total mortality was 15.69%. Increased heart rate, decreased arterial PH, hypoxia, high glucose, increased plasma creatinine and vasopressor use were associated with the poor outcome in patients with HAP. In all bacterial isolates from HAP, 64.90% were gram-negative bacilli bacteria, including Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. 26.5% of the isolates were Staphylococcus aureus and the rate of MRSA was 65.4%. Conclusion The elderly, cerebrovascular diseases, and diabetes are risk factors of HAP and septic shock is the most important complication associated with poor prognosis of HAP. In this setting, Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus (MRSA 60%) should be considered as the common etiologic pathogens of HAP.