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Article: Risk factors for drug-resistant bacterial pneumonia in older patients hospitalized with pneumonia in a Chinese population

TitleRisk factors for drug-resistant bacterial pneumonia in older patients hospitalized with pneumonia in a Chinese population
Authors
Issue Date2013
Citation
QJM, 2013, v. 106, n. 9, p. 823-829 How to Cite?
AbstractThe relationship between healthcareassociated pneumonia (HCAP) and resistant bacteria is unclear. The aim of this study was to identify the risk factors for pneumonia caused by drug-resistant bacteria (DRB). A prospective cohort study was conducted at a tertiary teaching hospital in Hong Kong. Consecutive older patients (aged ≥565 years) were hospitalized with pneumonia from January 2004 to June 2005. DRB comprised methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae and Acinetobacter baumannii. The entire cohort consisted of 1176 older patients. Of 472 (40.1%) patients with etiological diagnosis established, bacterial pneumonia was found in 354 (30.1%) cases. DRB were isolated in 48 patients: P. aeruginosa (41), MRSA (5) and ESBL producing enteric bacilli (3). Co-infection with P. aeruginosa and MRSA was found in one patient. The prevalence of DRB in culture-positive pneumonia was 20.1% (48/239). Patients with DRB were more likely to have limitation in activities of daily living, bronchiectasis, dementia, severe pneumonia, recent hospitalization and recent antibiotic use. Logistic regression revealed that bronchiectasis [relative risk (RR) 14.12, P = 0.002], recent hospitalization (RR 4.89, P < 0.001) and severe pneumonia (RR 2.42, P = 0.010) were independent predictors of drug-resistant bacterial pneumonia. Recent hospitalization is the only risk factor for HCAP which is shown to be associated with DRB. Nursing home residence is not a risk factor. The concept of HCAP may not be totally applicable in Hong Kong where the prevalence of drug-resistant pathogens in pneumonia is low. © The Author 2011. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/292790
ISSN
2023 Impact Factor: 7.3
2023 SCImago Journal Rankings: 0.626
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMa, H. M.-
dc.contributor.authorIp, Margaret-
dc.contributor.authorWoo, Jean-
dc.contributor.authorHui, David S.C.-
dc.contributor.authorLui, Grace C.Y.-
dc.contributor.authorLee, Nelson L.S.-
dc.contributor.authorChan, Paul K.S.-
dc.contributor.authorRainer, T. H.-
dc.date.accessioned2020-11-17T14:57:13Z-
dc.date.available2020-11-17T14:57:13Z-
dc.date.issued2013-
dc.identifier.citationQJM, 2013, v. 106, n. 9, p. 823-829-
dc.identifier.issn1460-2725-
dc.identifier.urihttp://hdl.handle.net/10722/292790-
dc.description.abstractThe relationship between healthcareassociated pneumonia (HCAP) and resistant bacteria is unclear. The aim of this study was to identify the risk factors for pneumonia caused by drug-resistant bacteria (DRB). A prospective cohort study was conducted at a tertiary teaching hospital in Hong Kong. Consecutive older patients (aged ≥565 years) were hospitalized with pneumonia from January 2004 to June 2005. DRB comprised methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae and Acinetobacter baumannii. The entire cohort consisted of 1176 older patients. Of 472 (40.1%) patients with etiological diagnosis established, bacterial pneumonia was found in 354 (30.1%) cases. DRB were isolated in 48 patients: P. aeruginosa (41), MRSA (5) and ESBL producing enteric bacilli (3). Co-infection with P. aeruginosa and MRSA was found in one patient. The prevalence of DRB in culture-positive pneumonia was 20.1% (48/239). Patients with DRB were more likely to have limitation in activities of daily living, bronchiectasis, dementia, severe pneumonia, recent hospitalization and recent antibiotic use. Logistic regression revealed that bronchiectasis [relative risk (RR) 14.12, P = 0.002], recent hospitalization (RR 4.89, P < 0.001) and severe pneumonia (RR 2.42, P = 0.010) were independent predictors of drug-resistant bacterial pneumonia. Recent hospitalization is the only risk factor for HCAP which is shown to be associated with DRB. Nursing home residence is not a risk factor. The concept of HCAP may not be totally applicable in Hong Kong where the prevalence of drug-resistant pathogens in pneumonia is low. © The Author 2011. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.-
dc.languageeng-
dc.relation.ispartofQJM-
dc.titleRisk factors for drug-resistant bacterial pneumonia in older patients hospitalized with pneumonia in a Chinese population-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/qjmed/hct152-
dc.identifier.pmid23853031-
dc.identifier.scopuseid_2-s2.0-84889048733-
dc.identifier.volume106-
dc.identifier.issue9-
dc.identifier.spage823-
dc.identifier.epage829-
dc.identifier.eissn1460-2393-
dc.identifier.isiWOS:000324874500006-
dc.identifier.issnl1460-2393-

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