TY - JOUR
T1 - Antimicrobial drug-resistant microbes associated with hospitalized community-acquired and healthcare-associated pneumonia
T2 - A multi-center study in Taiwan
AU - Wu, Chieh Liang
AU - Ku, Shih Chi
AU - Yang, Kuang Yao
AU - Fang, Wen Feng
AU - Tu, Chih Yen
AU - Chen, Chang Wen
AU - Hsu, Kuo Hsuan
AU - Fan, Wen Chien
AU - Lin, Meng Chih
AU - Chen, Wei
AU - Ou, Chih Ying
AU - Yu, Chong Jen
N1 - Funding Information:
We thank Ms. Ying-Chen Yen, Ms. Shiang-Ling King, and the Biostatistics Task Force of Taichung Veterans General Hospital for statistical assistance. This work was supported financially in part for the study administration and data analysis by Merck, Sharp & Dohme, Taiwan.
PY - 2013/1
Y1 - 2013/1
N2 - Background/Purpose: Community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) may be caused by potential antimicrobial drug-resistant (PADR) microbes. The aims of this study were to evaluate the incidences and risk factors associated with PADR microbes observed in patients with pneumonia occurring outside the hospital setting in Taiwan. Methods: We conducted a retrospective study of patients with CAP or HCAP admitted to six medical centers in the northern, central, and southern regions of Taiwan in 2007. The pathogens were evaluated by microbiological specimens within 72 hours after admission. The patients' comorbidities, pathogens, and outcomes were evaluated. The risk factors of PADR microbes were identified by logistic regression analysis. Results: The enrolled patients exhibited HCAP (n=713) and CAP (n=933). The pathogens associated with HCAP (n=383) and CAP (n=441) included Pseudomonas spp. (29%vs 10%, p<0.001), Klebsiella spp. (24% vs. 25%, p=0.250), Escherichia coli (6% vs. 8%, p=0.369), Haemophilus influnezae (3% vs. 7%, p=0.041), Streptococcus pneumoniae (2% vs. 6%, p=0.003) and methicillin-resistant Staphylococcus aureus (MRSA) (8% vs. 4%, p=0.008). The core pathogens of CAP and HCAP differed among the three regions of Taiwan. PADR microbes, including Pseudomonas spp. (n=191), Acinetobacter spp. (n=41), MRSA (n=49) and cefotaxime- or ceftazidime-resistant Enterbacteriaceae (n=25), were isolated from 13% of patients with CAP and 23% of patients with HCAP. Previous hospitalization, and neoplastic and neurological diseases were significant risk factors for acquiring PADR microbes. Conclusion: PADR microbes were common in patients with HCAP and CAP in Taiwan. Broad-spectrum antibiotics targeting PADR microbes should be administered to patients who have undergone previous hospitalization and who exhibit neurological disorders and/or malignancies.
AB - Background/Purpose: Community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) may be caused by potential antimicrobial drug-resistant (PADR) microbes. The aims of this study were to evaluate the incidences and risk factors associated with PADR microbes observed in patients with pneumonia occurring outside the hospital setting in Taiwan. Methods: We conducted a retrospective study of patients with CAP or HCAP admitted to six medical centers in the northern, central, and southern regions of Taiwan in 2007. The pathogens were evaluated by microbiological specimens within 72 hours after admission. The patients' comorbidities, pathogens, and outcomes were evaluated. The risk factors of PADR microbes were identified by logistic regression analysis. Results: The enrolled patients exhibited HCAP (n=713) and CAP (n=933). The pathogens associated with HCAP (n=383) and CAP (n=441) included Pseudomonas spp. (29%vs 10%, p<0.001), Klebsiella spp. (24% vs. 25%, p=0.250), Escherichia coli (6% vs. 8%, p=0.369), Haemophilus influnezae (3% vs. 7%, p=0.041), Streptococcus pneumoniae (2% vs. 6%, p=0.003) and methicillin-resistant Staphylococcus aureus (MRSA) (8% vs. 4%, p=0.008). The core pathogens of CAP and HCAP differed among the three regions of Taiwan. PADR microbes, including Pseudomonas spp. (n=191), Acinetobacter spp. (n=41), MRSA (n=49) and cefotaxime- or ceftazidime-resistant Enterbacteriaceae (n=25), were isolated from 13% of patients with CAP and 23% of patients with HCAP. Previous hospitalization, and neoplastic and neurological diseases were significant risk factors for acquiring PADR microbes. Conclusion: PADR microbes were common in patients with HCAP and CAP in Taiwan. Broad-spectrum antibiotics targeting PADR microbes should be administered to patients who have undergone previous hospitalization and who exhibit neurological disorders and/or malignancies.
UR - http://www.scopus.com/inward/record.url?scp=84872371180&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872371180&partnerID=8YFLogxK
U2 - 10.1016/j.jfma.2011.09.028
DO - 10.1016/j.jfma.2011.09.028
M3 - Article
C2 - 23332427
AN - SCOPUS:84872371180
SN - 0929-6646
VL - 112
SP - 31
EP - 40
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 1
ER -