Abstract
Pneumonia in cases with history of hospitalisation, hemodialysis, accomodation in nursing homes, receving ambulatory intravenous therapies and having decubitus ulcers is defined as health care associated pneumonia (HCAP).
The comparison of demographic data, isolated causative agents and prognosis of patients with community acquired pneumonia (CAP) and HCAP is aimed. The patients with HCAP and CAP registered by seven centers in the Turkish Thoracic Society Respiratory Infections Study Group pneumonia database were retrospectively evaluated.
785 cases (530 male, average age 65.3±16.4) were evaluated, 207 (26.4%) were diagnosed with HCAP and 578 (73.6%) with CAP. Among HCAP cases, 140/207 (17.8%) had recent hospitalisation in last 90 days, 28/207 (3.6%) went under hemodialysis in previous 30 days and 22/207 (2.8%) stayed in nursing homes. Pneumonia severity index (PSI), was 103.9±37.2 in HCAP and 94.6±35.4 in CAP (p=0.002). The most frequently isolated causitive microorganisms were; P.aeruginosa, A.baumannii and S.pneumoniae in HCAP and S.pneumoniae and P.aeruginosa in CAP. Although length of stay in hospital was higher in HCAP than CAP (8.6±5.5 vs 7.5±6.1 days, p=0.03), the differences in ratios of length of stay in critical care unit were not statistically significant (%9.7 vs %9.3) (p>0.005). Despite the mortality ratio in HCAP was higher than CAP (8.7% vs 5.7%), the difference was not statistically significant (p=0.14).
HCAP require special approach in the means of different reference data, range of isolated agents and prognosis other than CAP. Therapies involving gram negative microorganisms resistant to empirical antibiotherapies should be considered.
- © 2014 ERS
