Document Detail

Clinical features of healthcare-associated pneumonia (HCAP) in a Japanese community hospital: Comparisons among nursing home-acquired pneumonia (NHAP), HCAP other than NHAP, and community-acquired pneumonia.
MedLine Citation:
PMID:  21545370     Owner:  NLM     Status:  Publisher    
SUMMARY AT A GLANCE: There were differences in bacteriological findings and mortality rates among subgroups of Japanese patients with healthcare-associated pneumonia (HCAP). The HCAP guidelines of the American Thoracic Society/Infectious Diseases Society of America may not necessarily be applicable for accurate diagnosis and optimum treatment of all Japanese patients with HCAP. ABSTRACT: Background and objective:  More than 100,000 Japanese die of pneumonia every year. The number of people residing in nursing homes is increasing with the ageing of the population. In 2005, the American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) published important guidelines for the management of healthcare-associated pneumonia (HCAP). In Japan, however, the optimum strategy for management of HCAP is still unclear. The purpose of this study was to clarify the clinical features of patients with HCAP. Methods:  Patients (n= 202) who were consecutively admitted with a diagnosis of acute pneumonia between October 2007 and September 2009 were retrospectively evaluated. Using the ATS/IDSA guidelines, patients were divided into three groups: a community-acquired pneumonia (CAP) group (n= 123), a nursing home-acquired pneumonia (NHAP) group (n= 46), and a HCAP other than NHAP (O-HCAP) group (n= 33). These groups were then compared with respect to laboratory data, microbiological findings, and mortality. Results:  Thirty-day mortality in the NHAP group (10.9%) tended to be higher than that in the CAP group (3.3%) or the O-HCAP group (0%). The pathogens most frequently identified were Streptococcus pneumoniae and Haemophilus influenzae in the CAP group, methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae in the NHAP group, and S. pneumoniae and K. pneumoniae in the O-HCAP group. Conclusions:  The NHAP group was clinically different to the O-HCAP group, based on bacteriological examination and mortality rates. In order to accurately diagnose, and formulate optimum treatment strategies for Japanese patients, the categories of HCAP, as specified in the ATS/IDSA guidelines, should not be applied directly either to patients with NHAP or those with O-HCAP.
Kenji Umeki; Issei Tokimatsu; Chie Yasuda; Atsuko Iwata; Daisuke Yoshioka; Hiroshi Ishii; Ryo Shirai; Kenji Kishi; Kazufumi Hiramatsu; Bunroku Matsumoto; Jun-Ichi Kadota
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-4
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.
Internal Medicine II, Oita University Faculty of Medicine, Yufu, and Tenshindo Hetsugi Hospital, Oita, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Comparison of point-of-care testing (POCT): i-STAT(®) international normalized ratio (INR) vs refer...
Next Document:  Exhaled nitric oxide and exhaled breath condensate pH as predictors of sputum cell counts in optimal...