Ryoung-Eun Ko1, Kyung Hoon Min2, Sang-Bum Hong3, Ae-Rin Baek4, Hyun-Kyung Lee5, Woo Hyun Cho6, Changhwan Kim7, Youjin Chang8, Sung-Soon Lee9, Jee Youn Oh2, Heung Bum Lee10, Soohyun Bae11, Jae Young Moon12, Kwang Ha Yoo13, Kyeongman Jeon1,14. 1. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea. 3. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 4. Devision of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchun hyang University Bucheon Hospital, Bucheon, Korea. 5. Department of Internal Medicinn, Division of pulmonology, allergy and critical care medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. 6. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. 7. Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. 8. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea. 9. Division of Pulmonary and Critical Care Medicine, Departmen of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea. 10. Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School, Jeonju, Korea. 11. Deppartmen of Internal Medicine, Ulsan University Hospital, Ulsan, Korea. 12. Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea. 13. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. 14. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but domestic epidemiological data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. A total of 206,372 adult hospitalized patients at one of the 13 participating tertiary hospitals in Korea during a six-month period were screened for eligibility. Among these, patients diagnosed with HAP/VAP based on the IDSA/ATS definition for HAP/VAP were included in the study. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients among whom 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. The majority of patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 (40.1%) patients and multidrug resistant (MDR) pathogens were isolated in 138 patients in which the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 (28.2%) patients with HAP required additional ICU care. Hospital mortality was 28.1% in our cohort. Among the 378 patients who survived, 54.2% were discharged home and 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1000 patients. Patients with HAP/VAP from tertiary hospitals in Korea were elderly, had a risk of aspiration, and were often referred to step-down centers.
Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but domestic epidemiological data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. A total of 206,372 adult hospitalized patients at one of the 13 participating tertiary hospitals in Korea during a six-month period were screened for eligibility. Among these, patients diagnosed with HAP/VAP based on the IDSA/ATS definition for HAP/VAP were included in the study. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients among whom 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. The majority of patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 (40.1%) patients and multidrug resistant (MDR) pathogens were isolated in 138 patients in which the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 (28.2%) patients with HAP required additional ICU care. Hospital mortality was 28.1% in our cohort. Among the 378 patients who survived, 54.2% were discharged home and 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1000 patients. Patients with HAP/VAP from tertiary hospitals in Korea were elderly, had a risk of aspiration, and were often referred to step-down centers.
Authors: Hakjun Hyun; Joon Young Song; Jin Gu Yoon; Hye Seong; Ji Yun Noh; Hee Jin Cheong; Woo Joo Kim Journal: PLoS One Date: 2022-06-29 Impact factor: 3.752
Authors: Marya D Zilberberg; Brian H Nathanson; Laura A Puzniak; Ryan J Dillon; Andrew F Shorr Journal: BMC Infect Dis Date: 2022-10-05 Impact factor: 3.667