Antimicrobial drug-resistant microbes associated with hospitalized community-acquired and healthcare-associated pneumonia: A multi-center study in Taiwan

Chieh Liang Wu, Shih Chi Ku, Kuang Yao Yang, Wen Feng Fang, Chih Yen Tu, Chang Wen Chen, Kuo Hsuan Hsu, Wen Chien Fan, Meng Chih Lin, Wei Chen, Chih Ying Ou, Chong Jen Yu

研究成果: Article同行評審

28 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)31-40
頁數10
期刊Journal of the Formosan Medical Association
112
發行號1
DOIs
出版狀態Published - 2013 一月

All Science Journal Classification (ASJC) codes

  • 醫藥 (全部)

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