https://scholars.lib.ntu.edu.tw/handle/123456789/522036
標題: | Antimicrobial drug-resistant microbes associated with hospitalized community-acquired and healthcare-associated pneumonia: A multi-center study in Taiwan | 作者: | Wu C.-L. SHIH-CHI KU Yang K.-Y. Fang W.-F. Tu C.-Y. Chen C.-W. Hsu K.-H. Fan W.-C. Lin M.-C. Chen W. Ou C.-Y. CHONG-JEN YU |
公開日期: | 2013 | 卷: | 112 | 期: | 1 | 起(迄)頁: | 31-40 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) may be caused by potential antimicrobial drug-resistant (PADR) microbes. The aims of this study were to evaluate the incidences and risk factors associated with PADR microbes observed in patients with pneumonia occurring outside the hospital setting in Taiwan. Methods: We conducted a retrospective study of patients with CAP or HCAP admitted to six medical centers in the northern, central, and southern regions of Taiwan in 2007. The pathogens were evaluated by microbiological specimens within 72 hours after admission. The patients' comorbidities, pathogens, and outcomes were evaluated. The risk factors of PADR microbes were identified by logistic regression analysis. Results: The enrolled patients exhibited HCAP (n=713) and CAP (n=933). The pathogens associated with HCAP (n=383) and CAP (n=441) included Pseudomonas spp. (29%vs 10%, p<0.001), Klebsiella spp. (24% vs. 25%, p=0.250), Escherichia coli (6% vs. 8%, p=0.369), Haemophilus influnezae (3% vs. 7%, p=0.041), Streptococcus pneumoniae (2% vs. 6%, p=0.003) and methicillin-resistant Staphylococcus aureus (MRSA) (8% vs. 4%, p=0.008). The core pathogens of CAP and HCAP differed among the three regions of Taiwan. PADR microbes, including Pseudomonas spp. (n=191), Acinetobacter spp. (n=41), MRSA (n=49) and cefotaxime- or ceftazidime-resistant Enterbacteriaceae (n=25), were isolated from 13% of patients with CAP and 23% of patients with HCAP. Previous hospitalization, and neoplastic and neurological diseases were significant risk factors for acquiring PADR microbes. Conclusion: PADR microbes were common in patients with HCAP and CAP in Taiwan. Broad-spectrum antibiotics targeting PADR microbes should be administered to patients who have undergone previous hospitalization and who exhibit neurological disorders and/or malignancies. ? 2012. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84872371180&doi=10.1016%2fj.jfma.2011.09.028&partnerID=40&md5=10d0668dfd04073b8ef0a46fdb5f4907 https://scholars.lib.ntu.edu.tw/handle/123456789/522036 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2011.09.028 | SDG/關鍵字: | antibiotic agent; Acinetobacter; aged; antibiotic resistance; article; bacterium; bacterium isolation; community acquired pneumonia; Enterobacteriaceae; Escherichia coli; female; Haemophilus influenzae; hospitalization; human; incidence; Klebsiella; major clinical study; male; methicillin resistant Staphylococcus aureus; multicenter study (topic); nonhuman; pneumonia; Pseudomonas; risk factor; Streptococcus pneumoniae; Taiwan; Acinetobacter; Aged; Aged, 80 and over; Community-Acquired Infections; Cross Infection; Drug Resistance, Bacterial; Enterobacteriaceae; Escherichia coli; Female; Haemophilus influenzae; Hospitalization; Humans; Klebsiella; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Neoplasms; Nervous System Diseases; Pneumonia; Pseudomonas; Retrospective Studies; Risk Factors; Streptococcus pneumoniae; Taiwan |
顯示於: | 醫學系 |
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