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Turkish Journal of Medical Sciences
Year: 2010  |  Volume: 40  |  Issue: 3  |  Page No.: 357 - 363

Hospital-acquired pneumonia in nonintensive care unit wards

Meltem Avci, Onur Ozgenc, Ayten Coskuner, Berna Bozca, Levent Kidak, Gulsen Mermut, Mehmet Sezai Tasbakan, Neslihan Genc, Gulsen Guloglu and Alpay Ari    

Abstract: To determine the incidence, risk factors, etiology, and antibiotic susceptibility of hospital-acquired pneumonia (HAP) in nonintensive care units (non-ICU) and nonintubated adult patients. Materials and methods: A prospective surveillance study was performed from January 2006 through December 2007 in the medical and surgical wards of the Ýzmir Teaching and Research Hospital. Results: During the study period, data on 57,133 patients with a total of 413,515 patient-days were analyzed. A total of 106 HAP episodes occurred in 99 patients. The infection rate per 100 patients and per 1000 patient-days was found to be 0.2% and 0.3%, respectively. HAP episodes were detected mostly in medical wards (66%). The mean age of patients was 58.6 ± 15.9 and 73% of the patients were male. The most common intrinsic and extrinsic risk factors observed in patients with HAP, according to the first episode, were cardiovascular disease (47%), central nervous system disease (41%), malignancy (40%), hospitalization longer than 5 days (91%), antibiotic therapy (81%), previous endotracheal intubation (40%), nasogastric tubes (38%), and H2 receptor antagonist/antiacid (37%). Moreover, 109 microorganisms were isolated from 84% of HAP episodes. Overall, the most frequently isolated pathogens from HAP episodes were Klebsiella pneumoniae (23%), Escherichia coli (21%), and Staphylococcus aureus (18%). These were mostly multidrug-resistant. The crude mortality was found to be 25%. Conclusion: Surveillance of HAP in non-ICU and nonintubated adult patients provides valuable guidance for empirical antimicrobial therapy and infection control measures for some wards.

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