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

Sugisaki, Midori; Enomoto, Tatsuji; Shibuya, Yasuhiro; Matsumoto, Aki; Saitoh, Hitoshi; Shingu, Akiko; Narato, Ritsuko; Nomura, Koichiro

doi:10.1007/s10156-011-0344-9

Cited by 17 publications

(18 citation statements)

References 21 publications

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“…(22) In the present study, 50% of patients with HCAP received some antipseudomonal agent, but we could not assume that the antibiotic selections had contributed to the improvement in clinical outcome, even though the rates of occurrence of MDR pathogens, initial treatment failure and inappropriate antibiotic therapy among these patients were lower compared to other studies. (18)(19)(20)(21) The HCAP mortality rate worldwide and that reported in the present study are almost identical. Unfortunately, we could not determine the risk factors for HCAP mortality, as there was no clear relationship between HCAP mortality and the rates of occurrence of MDR pathogens or initial treatment failure.…”

Section: Discussionsupporting

confidence: 72%

“…(18) Jung et al showed via multivariate analysis that tube feeding and previous hospitalisation within 90 days of pneumonia onset were significant risk factors for frequency of occurrence of MDR pathogens. (20) In the present study, the rate of occurrence of MDR pathogens among patients with HCAP (15.0%) was relatively lower than that reported in other studies (12.6%-38.1%). (13,(17)(18)(19) Our rate of initial treatment failure for HCAP (1.4%) was also much lower than that reported in other studies (24.2%-35.9%).…”

Section: Discussioncontrasting

confidence: 53%

“…(18)(19)(20)(21) When severity is assessed using A-DROP and CURB-65, these aforementioned factors could result in underestimation of the severity of pneumonia in elderly patients with CAP or HCAP, as both of these prognostic guidelines do not take into consideration the presence of comorbidities in their evaluation of the severity of pneumonia, unlike PSI and I-ROAD. However, as evaluation of the severity of pneumonia using PSI is time-consuming due to the complicated nature of its calculations, its use in Japan is limited.…”

Section: Discussionmentioning

confidence: 99%

“…(16)(17)(18)(19) In contrast, the 30-day mortality rate among our patients with HCAP (18.9%) was similar to that reported in other studies (12%-29%). (18)(19)(20)(21) The contribution of MDR pathogens to the aetiology of HCAP and its empirical treatment, however, remains controversial. (19) Ewig et al opined that the concept of HCAP contributes to confusion, potentially leading to overtreatment.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

I-ROAD could be efficient in predicting severity of community-acquired pneumonia or healthcare-associated pneumonia

Matsunuma¹,

Asai²,

Ohkuni³

et al. 2014

Singapore Med J

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Section: Discussionsupporting

confidence: 72%

Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

I-ROAD could be efficient in predicting severity of community-acquired pneumonia or healthcare-associated pneumonia

Matsunuma¹,

Asai²,

Ohkuni³

et al. 2014

Singapore Med J

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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%

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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Hospital malnutrition in northeast and southeast Asia: A systematic literature review

Inciong

Chaudhary²,

Hsu

et al. 2020

Clinical Nutrition ESPEN

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Background & aims: Hospital malnutrition is a prevalent yet frequently under-recognised condition that is associated with adverse clinical and economic consequences. Systematic reviews from various regions of the world have provided regional estimates of the prevalence of malnutrition and the magnitude of the associated health and economic burden; however, a systematic assessment of the prevalence and consequences of hospital malnutrition in northeast and southeast Asia has not been conducted. Methods: We performed a systematic literature search for articles on hospital malnutrition in 11 Asian countries published in English between January 1, 1997 and January 15, 2018. Studies reporting data on the prevalence, clinical consequences, or economic impact of hospital malnutrition in an adult inpatient population with a sample size !30 were eligible for inclusion. Results: The literature search identified 3207 citations; of these, 92 studies (N ¼ 62,280) met the criteria for inclusion. There was substantial variability in study populations and assessment methods; however, a majority of studies reported a malnutrition prevalence of >40%. Malnutrition was associated with an increase in clinical complications, mortality, length of hospitalisation, hospital readmissions, and healthcare costs. Conclusions: Hospital malnutrition is a highly prevalent condition among hospitalised patients in northeast and southeast Asia. Additionally, poor nutritional status is associated with increased morbidity and mortality and increased healthcare costs. Further research aimed at improving the identification and proactive management of hospitalised patients at risk for malnutrition is necessary to improve patient outcomes and alleviate the burden on local healthcare budgets.

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

Cited by 17 publications

References 21 publications

I-ROAD could be efficient in predicting severity of community-acquired pneumonia or healthcare-associated pneumonia

I-ROAD could be efficient in predicting severity of community-acquired pneumonia or healthcare-associated pneumonia

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)

Hospital malnutrition in northeast and southeast Asia: A systematic literature review

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