Korean J Med.  2010 Jun;78(6):709-716.

The clinical and microbial characteristics of healthcare-associated pneumonia

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. kimch@knu.ac.kr
  • 2Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

BACKGROUND/AIMS
Healthcare-associated pneumonia (HCAP) occurs outside hospitals, but its characteristics are similar to those of hospital-acquired pneumonia (HAP). We evaluated the clinical and microbial characteristics of HCAP in Korea.
METHODS
Of 130 subjects with suspected pneumonia, 49 were classified as HCAP and 81 as HAP. We retrospectively examined the clinical presentations, outcomes, pathogens, and drug resistance rates of Pseudomonas aeruginosae in both groups.
RESULTS
The clinical presentations, including the symptoms and laboratory findings, at the time of hospitalization were comparable in both groups. The hospital mortalities of HCAP (28.6%) and HAP (34.6%) did not differ significantly; the length of the hospital stay was similar for all of the survivors (14 vs. 17 days, respectively). Of the identified pathogens, methicillin-resistant Staphylococcus aureus was significantly less common in HCAP than in HAP (two vs. 18 cases, respectively, p<0.01), whereas Klebsiella pneumoniae was more common in HCAP (five vs. zero cases, respectively, p<0.01). The frequency of other Gram-negative rods was similar in both groups. The rate of resistance to antibiotics in P. aeruginosae in both groups was substantial, with the highest resistant rate to ciprofloxacin (50% and 61.5% in HCAP and HAP, respectively).
CONCLUSIONS
Although the clinical features and outcomes of HCAP were comparable to those of HAP in the study population, the frequency of methicillin-resistant S. aureus was significantly lower in HCAP compared to HAP.

Keyword

Healthcare-associated pneumonia; Hospital-acquired pneumonia

MeSH Terms

Anti-Bacterial Agents
Ciprofloxacin
Drug Resistance
Hospital Mortality
Hospitalization
Humans
Klebsiella pneumoniae
Korea
Length of Stay
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Pneumonia
Pseudomonas aeruginosa
Retrospective Studies
Survivors
Anti-Bacterial Agents
Ciprofloxacin
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