Chest
Original ResearchRespiratory InfectionHealth-Care-Associated Pneumonia Among Hospitalized Patients in a Japanese Community Hospital
Section snippets
Study Design and Patient Population
We conducted a retrospective observational study of patients with pneumonia hospitalized at Handa City Hospital (a 500-bed community hospital in Handa City, Aichi, Japan) between November 1, 2005, and January 31, 2007. Patients with HAP were excluded. We categorized the study patients into HCAP or CAP groups, and compared baseline characteristics, disease severity, pathogen distribution, antibiotic regimens, and outcomes between the pneumonia groups. We adhered to the Japanese ethical
Patient Characteristics
A total of 371 patients were evaluated during the study period, comprising 141 patients with HCAP (38.0%) and 230 patients with CAP (62.0%). The backgrounds of the 141 HCAP patients are shown in Table 1, and the baseline characteristics of patients with HCAP and CAP are presented in Table 2.
Pathogen Distribution
The microbes identified in the HCAP and CAP groups are shown in Table 3. Laboratory cultures were obtained from the respiratory tracts of 132 of 141 HCAP patients (93.6%) and 224 of 230 CAP patients (97.4%).
Discussion
This retrospective study has shown differences in baseline characteristics, disease severity, identified pathogens, initial antibiotic regimens, and clinical outcomes between HCAP and CAP patients. We especially focused on differences in mortality and identified pathogens in each severity class between HCAP and CAP patients. We found significant differences in the in-hospital mortality and occurrence of PDR pathogens in the moderate class between HCAP and CAP patients, but not in the severe
Acknowledgment
We thank Professor Michio Ohta (Department of Molecular Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan) for his comments on the microbiological evaluation.
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