Abstract
[Background] Enteral feeding may cause the elevated risk of multidrug-resistant(MDR)pathogens in healthcare-associated pneumonia(HCAP). A better understanding of their clinical features is needed.The Japan Respiratory Society documented a new category,nursing and healthcare-associated pneumonia(NHCAP).The criteria were;(1)residence in a nursing home or an extended-care ward,(2)a discharge from a hospital in the preceding 90 days,(3)an elderly or handicapped patient who needs long-term care,(4)a patient who regularly requires vascular access in an outpatient setting.[Objectives] To evaluate clinical characteristics of NHCAP patients who underwent tube feeding,and to compare the features of the patients with or without enteral nutrition.[Methods] Retrospective study of 412 hospitalized NHCAP patients at a single center.[Results] Fifty-one patients(12.3%)underwent enteral feeding(49 percutaneous endoscopic gastrostomy tube,2 nasogastric tube).Mean age; 78±15. Forty sputum samples(78.4%)were evaluated,which included 9(22.5%)acceptable specimens judged by the criteria of Geckler. MDR pathogens were isolated in 4(10.0%)(Pseudomonas aeruginosa, MRSA, ESBL producing bacteria, and Acinetobacter in each patient).The 30-day mortality rate was 16.0%. Compared with patients without tube feeding,those with enteral nutrition were younger and more likely to have cerebral infarction and Parkinson disease.[Conclusion] The population presented a higher rate of neurological complications,which may cause inadequate sputum specimens.Careful interpretation of bacteriological examination should be done to select appropriate antibiotics.
- © 2014 ERS
