Characteristics and disease severity of healthcare-associated pneumonia among patients in a hospital in Kitakyushu, Japan

Seki, Masafumi; Hashiguchi, Kohji; Tanaka, Akira; Kosai, Kosuke; Kakugawa, Tomoyuki; Awaya, Yukikazu; Kurihara, Shintaro; Izumikawa, Koichi; Kakeya, Hiroshi; Yamamoto, Yoshihiro; Yanagihara, Katsunori; Tashiro, Takayoshi; Kohno, Shigeru

doi:10.1007/s10156-010-0127-8

Cited by 36 publications

(19 citation statements)

References 18 publications

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“…To our knowledge, several major studies have investigated the differences in the characteristics of patients with HCAP and CAP: four from Japan [11][12][13][14], two from the United States [3][4][5], and one each from the UK [7], Spain [15], Italy [16], and Korea [17]. To discuss the characteristics of patients with HCAP, it is important to compare the patient selection in each report, because insurance and can receive health care impartially, a distinctive characteristic of the reports from Japan.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan

Sugisaki

Enomoto

Shibuya

et al. 2012

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan

Sugisaki

Enomoto

Shibuya

et al. 2012

Journal of Infection and Chemotherapy

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“…They concluded that HCAP is a heterogeneous disease and not all HCAP patients require a broad-spectrum multidrug regimen. Actually, several reports [10,13,[18][19][20] from Japan showed various values of frequency of MDR-pathogens and mortality rate of HCAP patients: frequency of MDR-pathogens was 3.3% to 42.9%; and mortality rate was 1.8% to 21.3%. In addition, the recent Japanese study [20] reported that the characteristics of HCAP patients are different between those admitted to large hospitals or small hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…Patients are diagnosed with NHCAP when they met at least one of the following criteria: (1) having been admitted to the long-term care hospital or nursing home; (2) discharge from hospital in the preceding 90 days; (3) elder or physically disability people who need care (ECOG PS score ≥3); (4) outpatients who receive infusion therapy (including dialysis, antibiotics, anticancer agent, and immunosuppressant drug). Complications were defined as described previously [9][10][11][12][13].…”

Section: Definitionsmentioning

confidence: 99%

The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP)

Kaku

Yanagihara

Morinaga

et al. 2013

Journal of Infection and Chemotherapy

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Healthcare-associated pneumonia (HCAP) is a new concept of pneumonia, which was proposed in ATS/IDSA guidelines. The guidelines explain that HCAP patients should be treated with broad-spectrum antimicrobial drugs directed at multidrug-resistant (MDR)-pathogens. However, in Japan, there are many elderly people who received an in-home care service. They seemed to be consistent with the concept of HCAP, but they didn't meet the definition of HCAP. Therefore, the Japanese Respiratory Society modified the definition of HCAP according to medical environmental in Japan. We retrospectively observed HCAP patients and nursing and healthcare-associated pneumonia (NHCAP) patients who were hospitalized between 24 months at the Japanese Red Cross Nagasaki Genbaku Hospital (Nagasaki, Japan). Patient background, disease severity, identified pathogens, initial antibiotic regimens, and outcomes were compared. A total of 108 patients (77 HCAP and 31 NHCAP except HCAP patients) were evaluated. Of NHCAP except HCAP patients, 27 (87.1%) were over 3 in ECOG PS score. There were almost no significantly differences between two groups in the characteristics, pneumonia severity, identified bacteria, initial antibiotic regimens, and response rate of initial antibiotic therapy. Although the in-hospital mortality of HCAP patients and NHCAP except HCAP patients was 9.1% and 19.4%, respectively, this difference did not reach Kaku et al., Page 3 statistical significance (P>0.05). Our study suggested that, in the criteria of HCAP, some Japanese patients, who were consistent with the concept of HCAP, were classified into community-acquired pneumonia. Therefore, there is a need to change the definition of HCAP according to medical environment in Japan.

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“…Outbreaks in intensive care wards with bronchoscopes and transesophageal echocardiogram (TEE) probes were traced to damage to instruments and a lack of leak testing [18,42,43]. In the current ERCP-associated outbreaks minor defects were detected on the duodenoscopes at the distal end, on the outer sheath, on the elevator enclosure and on cover lenses, which were apparently not discovered during reprocessing or during use of the instruments, but only following the outbreak during servicing [19,20,21,22,23,24].…”

Section: Ensuring Reprocessing Quality and Infection Preventionmentioning

confidence: 99%

Hygiene: The Looming Achilles Heel in Endoscopy

Jung¹,

Beilenhoff²

2016

Visc Med

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Background: Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. Infections by multidrug-resistant organisms (MDRO) have an increasing impact on healthcare systems worldwide. Since 2010 outbreaks involving MDRO have been reported as a result of endoscopic retrograde cholangiopancreatography (ERCP) from the USA, France, Germany and the Netherlands. Methods: This article evaluates the recent outbreaks and developments and demonstrates a structural approach to how to prevent future infections. Current national and international guidelines were used as a basis for discussions. Results: In some cases insufficient cleaning or drying supported the outbreak. In the majority of cases, outbreaks occurred despite the apparently appropriate reprocessing protocols being in use. Microlesions were identified on a number of endoscopes, which supported the growth of bacteria and represented a vehicle for the transmission of infectious material. National official bodies responded with warnings. Manufacturers informed their customers accordingly. Separate, purpose-designed reprocessing rooms and a sufficient number of competent staff provide the structural quality for a safe reprocessing. The process quality includes a thorough cleaning of all endoscope channels and crucial instrument components, followed by an automated and validated reprocessing procedure. Strict adherence to manufacturers' recommendations is essential. The outcome quality should be evaluated by regular audits, validation of reprocessing procedures and microbiological surveillance. If outbreaks occur, a close co-operation with official bodies and manufacturers is essential. Conclusion: Health care professionals and manufacturers should be aware of their responsibility to ensure patient safety. A structural approach is key in prevention of endoscopy-associated infections.

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Characteristics and disease severity of healthcare-associated pneumonia among patients in a hospital in Kitakyushu, Japan

Cited by 36 publications

References 18 publications

Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan

Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan

The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP)

Hygiene: The Looming Achilles Heel in Endoscopy

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