Yonsei Med J.  2011 Mar;52(2):282-287. 10.3349/ymj.2011.52.2.282.

The Difference in Clinical Presentations between Healthcare-Associated and Community-Acquired Pneumonia in University-Affiliated Hospital in Korea

• Jeon EJ
• Cho SG
• Shin JW
• Kim JY
• Park IW
• Choi BW
• Choi JC

• KMID: 1779664
• DOI: http://doi.org/10.3349/ymj.2011.52.2.282

Abstract

PURPOSE
Healthcare-associated pneumonia (HCAP) has been proposed as a new category of pneumonia. However, epidemiological studies for HCAP in South Korea are limited. This study aimed to reveal the differences between HCAP and community-acquired pneumonia (CAP), especially in elderly patients, in university-affiliated hospital in South Korea.
MATERIALS AND METHODS
We conducted a retrospective observational study of patients with HCAP and CAP (older than 60 years old) who were hospitalized between January 2007 and December 2008. We compared the baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics, and clinical outcomes.
RESULTS
A total of 210 patients were evaluated, including 35 patients with HCAP (17%) and 175 with CAP (83%). The most common causative organism was Streptococcus pneumoniae in CAP (33.3%), whereas, Staphylococcus aureus was most common pathogen in HCAP (40.0%). Initial inappropriate antibiotics (6.3% vs. 22.9%; p < 0.005) and initial treatment failure (15.4% vs. 31.4%; p = 0.018) were more frequent in HCAP than CAP. However, mortality (11.4% vs. 5.7%; p = 0.369) was not different between the two groups.
CONCLUSION
The present study provides additional evidence that HCAP should be distinguished from CAP, even in elderly patients, in South Korea. Physicians should consider S. aureus and MDR pathogens in selecting initial empirical antibiotics of HCAP in South Korea.

Keyword

Health care; pneumonia; epidemiology

MeSH Terms

Aged
Aged, 80 and over
Anti-Bacterial Agents/therapeutic use
Community-Acquired Infections/*diagnosis/drug therapy/microbiology
Cross Infection/*diagnosis/drug therapy/microbiology
Female
Hospitals, University
Humans
Male
Middle Aged
Pneumonia, Bacterial/*diagnosis/drug therapy/microbiology
Pneumonia, Pneumococcal/diagnosis/drug therapy
Pneumonia, Staphylococcal/diagnosis/drug therapy
Republic of Korea
Treatment Outcome

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