Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

Myoung Kyu Lee, Sang Ha Kim, Suk Joong Yong, Kye Chul Shin, Hyeon Cheol Park, Jiwon Choi, Yeun Seoung Choi, Jae Ho Seong, Ye Ryung Jung, Won Yeon Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results Out of 428 patients reviewed (male, 67.1%; mean age, 71.2±11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8±13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3– level, duration of ICU stay, extended spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP.

Original languageEnglish
Pages (from-to)236-249
Number of pages14
JournalJournal of International Medical Research
Volume43
Issue number2
DOIs
Publication statusPublished - 2015 Apr 19

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Intensive care units
Nursing
Intensive Care Units
Pneumonia
Delivery of Health Care
Acinetobacter baumannii
Mortality
Klebsiella pneumoniae
Respiratory Care Units
Dialysis
Immunosuppressive Agents
Disabled Persons
Nursing Homes
Outpatients
Demography
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Cell Biology
  • Biochemistry, medical

Cite this

Lee, Myoung Kyu ; Kim, Sang Ha ; Yong, Suk Joong ; Shin, Kye Chul ; Park, Hyeon Cheol ; Choi, Jiwon ; Choi, Yeun Seoung ; Seong, Jae Ho ; Jung, Ye Ryung ; Lee, Won Yeon. / Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia. In: Journal of International Medical Research. 2015 ; Vol. 43, No. 2. pp. 236-249.
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abstract = "Objective To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results Out of 428 patients reviewed (male, 67.1{\%}; mean age, 71.2±11.9 years), 30-day mortality was 25.5{\%}, and duration of ICU stay was 13.8±13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3– level, duration of ICU stay, extended spectrum {\ss}-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP.",
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Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia. / Lee, Myoung Kyu; Kim, Sang Ha; Yong, Suk Joong; Shin, Kye Chul; Park, Hyeon Cheol; Choi, Jiwon; Choi, Yeun Seoung; Seong, Jae Ho; Jung, Ye Ryung; Lee, Won Yeon.

In: Journal of International Medical Research, Vol. 43, No. 2, 19.04.2015, p. 236-249.

Research output: Contribution to journalArticle

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T1 - Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

AU - Lee, Myoung Kyu

AU - Kim, Sang Ha

AU - Yong, Suk Joong

AU - Shin, Kye Chul

AU - Park, Hyeon Cheol

AU - Choi, Jiwon

AU - Choi, Yeun Seoung

AU - Seong, Jae Ho

AU - Jung, Ye Ryung

AU - Lee, Won Yeon

PY - 2015/4/19

Y1 - 2015/4/19

N2 - Objective To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results Out of 428 patients reviewed (male, 67.1%; mean age, 71.2±11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8±13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3– level, duration of ICU stay, extended spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP.

AB - Objective To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results Out of 428 patients reviewed (male, 67.1%; mean age, 71.2±11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8±13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3– level, duration of ICU stay, extended spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP.

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