Bacterial etiology and mortality rate in community-acquired pneumonia, healthcare-associated pneumonia and hospital-acquired pneumonia in Thai university hospital

Abstract

Pneumonia is caused by infection at the pulmonary parenchyma which constitutes a crucial risk factor for morbidity and mortality. We aimed to determine the mortality rate and its risk factors as well as etiology among inpatients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and healthcare-associated pneumonia (HCAP). A hospital-based retrospective cohort study was conducted in a university hospital located in Bangkok, Thailand. A total of 250 inpatients with pneumonia was included in the present study. The inhospital mortality rate was 1.25 (95% CI 0.99–1.56) per 100 person-days. The present study reported that overall pneumonia caused by gram-negative pathogens accounted for 60.5%. P. aeruginosa was a frequent gram-negative pathogen among these participants, especially among patients with HCAP and HAP. Adjusted hazard ratio (AHR) of inhospital mortality among patients with HAP was 1.75 (95% CI 1.01–3.03) times that of those among patients with CAP, while AHR for 28-day mortality among patients with HAP compared with those with CAP was 2.81 (95% CI 1.38–5.75). Individual risks factors including cardiomyopathy, active-smoker and insulin use were potential risk factors for mortality. Initial qSOFA and acid-based disturbance should be assessed to improve proper management and outcomes.

Characteristics, Outcomes, and Factors Affecting Mortality in Hospitalized Patients with CAP Due to Different Variants of SARS-CoV-2 and Non-COVID-19 CAP

“…First, the clinical condition of the enrolled patients was relatively severe with an initial APACHE score of 17 and a respiratory failure rate of 11% at admission, when compared to previous data on the patients with CAP [ 27 ]. Second, the percentage of identifiable causative pathogens were higher (75.2%) in our study cohort than in previous reports [ 9 , 10 , 11 , 28 , 29 , 30 ]. These can be explained by the obvious presenting symptoms of the patients; for example, a large amount of sputum or intubation for mechanical ventilation aiding specimen (sputum) collection and raised the sensitivity for diagnosis.…”

Gram-negative pulmonary infections – advances in epidemiology and diagnosis

“…A large surveillance analysis on patients in Europe, North America and Latin America reported nonfermentative GNB in 28% of cases (with P. aeruginosa accounting for 22% of cases), Enterobacterales in a further 23% (with K. pneumoniae the most prevalent), while gram-positive cocci were mainly represented by S. aureus, accounting for 28% of cases [11]. Asian countries reported even higher prevalences of nonfermentative organisms from 31 to 71% of VAP cases [12][13][14].…”

Preventing biofilm formation and eradicating pathogenic bacteria by Zn doped histidine derived carbon quantum dots

“…In particular, bacterial co-infections and secondary infections are common in COVID-19 positive patients, 10 as well as in patients suffering from skeletal infections 11 and healthcare-associated pneumonia. 12 Thus, finding new antimicrobial preparations is a high-priority task of public health worldwide. degradation or photocatalysts, 17 chemiluminescence, 18 solar cells, 19 nano-electronic devices, 20 COVID-19 treatment, 21 photodynamic therapy, 22 and gene delivery.…”

“…In particular, bacterial co-infections and secondary infections are common in COVID-19 positive patients, 10 as well as in patients suffering from skeletal infections 11 and healthcare-associated pneumonia. 12 Thus, finding new antimicrobial preparations is a high-priority task of public health worldwide.…”