The difference in clinical presentations between healthcare-associated and community-acquired pneumonia in university-affiliated hospital in Korea

• Published in: Yonsei medical journal Vol. 52; no. 2; pp. 282 - 287
• Main Authors: Jeon, Eun Ju, Cho, Sung-Gun, Shin, Jong Wook, Kim, Jae Yeol, Park, In Won, Choi, Byoung Whui, Choi, Jae Chol
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.03.2011; 연세대학교의과대학
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Community-Acquired Infections - diagnosis; Community-Acquired Infections - drug therapy; Community-Acquired Infections - microbiology; Cross Infection - diagnosis; Cross Infection - drug therapy; Cross Infection - microbiology; Female; Hospitals, University; Humans; Male; Middle Aged; Original; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - drug therapy; Pneumonia, Bacterial - microbiology; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Pneumococcal - drug therapy; Pneumonia, Staphylococcal - diagnosis; Pneumonia, Staphylococcal - drug therapy; Republic of Korea; Treatment Outcome; 의학일반; Republic of Korea
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2011.52.2.282

Healthcare-associated pneumonia (HCAP) has been proposed as a new category of pneumonia. However, epidemiological studies for HCAP in South Korea are limited. This study aimed to reveal the differences between HCAP and community-acquired pneumonia (CAP), especially in elderly patients, in university-affiliated hospital in South Korea. We conducted a retrospective observational study of patients with HCAP and CAP (older than 60 years old) who were hospitalized between January 2007 and December 2008. We compared the baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics, and clinical outcomes. A total of 210 patients were evaluated, including 35 patients with HCAP (17%) and 175 with CAP (83%). The most common causative organism was Streptococcus pneumoniae in CAP (33.3%), whereas, Staphylococcus aureus was most common pathogen in HCAP (40.0%). Initial inappropriate antibiotics (6.3% vs. 22.9%; p < 0.005) and initial treatment failure (15.4% vs. 31.4%; p = 0.018) were more frequent in HCAP than CAP. However, mortality (11.4% vs. 5.7%; p = 0.369) was not different between the two groups. The present study provides additional evidence that HCAP should be distinguished from CAP, even in elderly patients, in South Korea. Physicians should consider S. aureus and MDR pathogens in selecting initial empirical antibiotics of HCAP in South Korea.