Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study
Introduction: Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all...
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| Format: | Article |
| Language: | English |
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Ordem dos Médicos
2019-12-01
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| Series: | Acta Médica Portuguesa |
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| Online Access: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11607 |
| _version_ | 1798021269569929216 |
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| author | Rui Dias Costa João Pedro Baptista Ricardo Freitas Paulo Jorge Martins |
| author_facet | Rui Dias Costa João Pedro Baptista Ricardo Freitas Paulo Jorge Martins |
| author_sort | Rui Dias Costa |
| collection | DOAJ |
| description |
Introduction: Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all episodes of Hospital-acquired pneumonia in our unit.
Material and Methods: Prospective observational study, at a tertiary university hospital during one year (2014) including all the cases of hospital-acquired pneumonia in the intensive care unit.
Results: Sixty patients were identified with pneumonia. Thirty-five (58.3%) had an intensive care unit acquired pneumonia, corresponding to 6.9 cases/1000 intubation-days. Antibiotic treatment in the previous 30 days was present in 75% of the cases. The incidence of Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii was 26.2%, 20.0% and 9.2%, respectively. Patients with late-onset hospital-acquired pneumonia (≥ 7 days) showed higher frequency of non-fermenting Gram-negative bacilli isolates, and methicillin-resistant S. aureus. Combination therapy was performed in 67.0%, and de-escalation in 18.3%. The mortality rate was 18.3%. The adjusted odds ratio for intensive care unit mortality in the group of patients with non-intensive care unit acquired pneumonia was 5.2 (95% CI of 1.02 – 22.10; p = 0.046).
Discussion: The knowledge of local bacterial flora and resistance patterns is of crucial importance and strongly recommended. This evidence increases the probability of success of empiric antibiotic therapy.
Conclusion: S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia.
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| first_indexed | 2024-04-11T17:10:57Z |
| format | Article |
| id | doaj.art-0380d1601a294e23ae4331dd198548b4 |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-04-11T17:10:57Z |
| publishDate | 2019-12-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-0380d1601a294e23ae4331dd198548b42022-12-22T04:12:54ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582019-12-01321210.20344/amp.116075012Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective StudyRui Dias Costa0João Pedro Baptista1Ricardo Freitas2Paulo Jorge Martins3Department of Internal Medicine. Centro Hospitalar Tondela-Viseu. Viseu.Department of Intensive Care. Centro Hospitalar e Universitário de Coimbra. Coimbra.Department of Intensive Care. Centro Hospitalar e Universitário de Coimbra. Coimbra.Department of Intensive Care. Centro Hospitalar e Universitário de Coimbra. Coimbra. Introduction: Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all episodes of Hospital-acquired pneumonia in our unit. Material and Methods: Prospective observational study, at a tertiary university hospital during one year (2014) including all the cases of hospital-acquired pneumonia in the intensive care unit. Results: Sixty patients were identified with pneumonia. Thirty-five (58.3%) had an intensive care unit acquired pneumonia, corresponding to 6.9 cases/1000 intubation-days. Antibiotic treatment in the previous 30 days was present in 75% of the cases. The incidence of Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii was 26.2%, 20.0% and 9.2%, respectively. Patients with late-onset hospital-acquired pneumonia (≥ 7 days) showed higher frequency of non-fermenting Gram-negative bacilli isolates, and methicillin-resistant S. aureus. Combination therapy was performed in 67.0%, and de-escalation in 18.3%. The mortality rate was 18.3%. The adjusted odds ratio for intensive care unit mortality in the group of patients with non-intensive care unit acquired pneumonia was 5.2 (95% CI of 1.02 – 22.10; p = 0.046). Discussion: The knowledge of local bacterial flora and resistance patterns is of crucial importance and strongly recommended. This evidence increases the probability of success of empiric antibiotic therapy. Conclusion: S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia. https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11607Cross InfectionDrug ResistanceMultipleBacterialHealthcare-Associated PneumoniaIntensive Care Units |
| spellingShingle | Rui Dias Costa João Pedro Baptista Ricardo Freitas Paulo Jorge Martins Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study Acta Médica Portuguesa Cross Infection Drug Resistance Multiple Bacterial Healthcare-Associated Pneumonia Intensive Care Units |
| title | Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study |
| title_full | Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study |
| title_fullStr | Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study |
| title_full_unstemmed | Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study |
| title_short | Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study |
| title_sort | hospital acquired pneumonia in a multipurpose intensive care unit one year prospective study |
| topic | Cross Infection Drug Resistance Multiple Bacterial Healthcare-Associated Pneumonia Intensive Care Units |
| url | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11607 |
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