An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study
BackgroundIn the population of abdominal surgical patients hospital-acquired pneumonia (HAP) significantly increases morbidity and mortality.Patients and methodsThrough regular hospital surveillance of patients who received abdominal operations, we identified postoperative HAP from 2007 to 2019. In...
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1040654/full |
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| author | Ðorde Taušan Nemanja Rančić Nemanja Rančić Zoran Kostić Zoran Kostić Nenad Ljubenović Bojan Rakonjac Vesna Šuljagić Vesna Šuljagić |
| author_facet | Ðorde Taušan Nemanja Rančić Nemanja Rančić Zoran Kostić Zoran Kostić Nenad Ljubenović Bojan Rakonjac Vesna Šuljagić Vesna Šuljagić |
| author_sort | Ðorde Taušan |
| collection | DOAJ |
| description | BackgroundIn the population of abdominal surgical patients hospital-acquired pneumonia (HAP) significantly increases morbidity and mortality.Patients and methodsThrough regular hospital surveillance of patients who received abdominal operations, we identified postoperative HAP from 2007 to 2019. In an initial nested case-control study, every surgical patient with HAP was compared with three control patients without HAP. Control patients were matched to the cases by age, gender, the American Society of Anesthesiologists score, and type of surgical operation. Also, the patients with HAP, who died were compared with those who survived.ResultsMultivariate logistic regression analysis (MLRA) revealed that other postoperative infections, length of intensive care unit stay, use of H2RA, use of PPI/ H2RA, multiple transfusion, and use of vancomycin in surgical prophylaxis were independent RFs for occurrence of HAP. Also, MLRA identified that age, lenght of hospital stay, use of mechanical ventilation and ceftriaxone in HAP therapy were indepedenttly associated with poor outcome of HAP. All Acinetobacter baumannii isolates were resistant to aminoglycoside antimicrobial agents and showed carbapenem resistance. The most frequently used antibiotics in patients with HAP and without HAP were vancomycin and metronidazole, respectively.ConclusionOur study provided an insight into the burden of HAP in abdominal surgical patients, and highlighted several priority areas and targets for quality improvement. |
| first_indexed | 2024-04-12T03:36:11Z |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T03:36:11Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-09000a9828ee4e4487c474329f7ed68b2022-12-22T03:49:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-12-01910.3389/fmed.2022.10406541040654An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control studyÐorde Taušan0Nemanja Rančić1Nemanja Rančić2Zoran Kostić3Zoran Kostić4Nenad Ljubenović5Bojan Rakonjac6Vesna Šuljagić7Vesna Šuljagić8Pulmonology Clinic, Military Medical Academy, Belgrade, SerbiaCenter for Clinical Pharmacology, Military Medical Academy, Belgrade, SerbiaMedical Faculty, University of Defence, Belgrade, SerbiaMedical Faculty, University of Defence, Belgrade, SerbiaClinic for General Surgery, Military Medical Academy, Belgrade, SerbiaInstitute of Epidemiology, Military Medical Academy, Belgrade, SerbiaInstitute of Medical Microbiology, Military Medical Academy, Belgrade, SerbiaMedical Faculty, University of Defence, Belgrade, SerbiaDepartment of Healthcare-Associated Infection Prevention and Control, Military Medical Academy, Belgrade, SerbiaBackgroundIn the population of abdominal surgical patients hospital-acquired pneumonia (HAP) significantly increases morbidity and mortality.Patients and methodsThrough regular hospital surveillance of patients who received abdominal operations, we identified postoperative HAP from 2007 to 2019. In an initial nested case-control study, every surgical patient with HAP was compared with three control patients without HAP. Control patients were matched to the cases by age, gender, the American Society of Anesthesiologists score, and type of surgical operation. Also, the patients with HAP, who died were compared with those who survived.ResultsMultivariate logistic regression analysis (MLRA) revealed that other postoperative infections, length of intensive care unit stay, use of H2RA, use of PPI/ H2RA, multiple transfusion, and use of vancomycin in surgical prophylaxis were independent RFs for occurrence of HAP. Also, MLRA identified that age, lenght of hospital stay, use of mechanical ventilation and ceftriaxone in HAP therapy were indepedenttly associated with poor outcome of HAP. All Acinetobacter baumannii isolates were resistant to aminoglycoside antimicrobial agents and showed carbapenem resistance. The most frequently used antibiotics in patients with HAP and without HAP were vancomycin and metronidazole, respectively.ConclusionOur study provided an insight into the burden of HAP in abdominal surgical patients, and highlighted several priority areas and targets for quality improvement.https://www.frontiersin.org/articles/10.3389/fmed.2022.1040654/fullantibioticsdrug consumptionsabdominal surgeryrisk factorsin-hospital mortalityAcinetobacter spp. |
| spellingShingle | Ðorde Taušan Nemanja Rančić Nemanja Rančić Zoran Kostić Zoran Kostić Nenad Ljubenović Bojan Rakonjac Vesna Šuljagić Vesna Šuljagić An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study Frontiers in Medicine antibiotics drug consumptions abdominal surgery risk factors in-hospital mortality Acinetobacter spp. |
| title | An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study |
| title_full | An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study |
| title_fullStr | An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study |
| title_full_unstemmed | An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study |
| title_short | An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study |
| title_sort | assessment of burden of hospital acquired pneumonia among abdominal surgical patients in tertiary university hospital in serbia a matched nested case control study |
| topic | antibiotics drug consumptions abdominal surgery risk factors in-hospital mortality Acinetobacter spp. |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1040654/full |
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