한빛사논문
- 조회377
Min Hyuk Choi a,b, Dokyun Kim a,b, Kyoung Hwa Lee c,d, Jae Hwa Cho d, Seok Hoon Jeong a,b
aDepartment of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, South Korea
bResearch Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
cDivision of Infectious Diseases, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, South Korea
dDepartment of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, South Korea
Corresponding author: Seok Hoon Jeong, MD, Ph.D.
Abstract
Background: We aimed to evaluate changes in the prevalence of hospital-acquired bacterial pneumonia (HABP)-causing pathogens and their antimicrobial resistance patterns in recent years and to identify risk factors for 28-day all-cause mortality (ACM) in patients with HABP.
Methods: A propensity score-matched study was performed by randomly allocating patients with ventilator-associated and non-ventilator-associated bacterial pneumonia admitted to two university hospitals between 2011 and 2021.
Results: A total of 17,250 HABP patients were enrolled. The annual incidence of Staphylococcus aureus-HABP decreased during the study period, while that of Klebsiella pneumoniae-HABP significantly increased yearly. During the same period, the resistance rate of S. aureus to methicillin decreased from 88.4% to 64.4%, while the nonsusceptibility rate of K. pneumoniae to carbapenems increased from 0% to 38%. HABP caused by A. baumannii (aOR 1.50; 95% CI 1.25-1.79), K. pneumoniae (1.28; 1.16-1.40), and Stenotrophomonas maltophilia (1.32; 1.05-1.66) was a risk factor for 28-day ACM. HABP caused by methicillin-resistant S. aureus and carbapenem-nonsusceptible A. baumannii or K. pneumoniae showed a significantly low survival probability. HABP with preceding COVID-19 infection was related to both a high 28-day ACM rate (5.40; 3.03-9.64) and a high incidence of bacteraemic pneumonia (40.55; 5.26-312.79).
Conclusions: This study showed shifting trends of HABP-causing microorganisms in terms of annual incidence accompanied by shifting trends of their resistance rates to major therapeutic antimicrobial agents. HABP-causing bacterial pathogens, their antimicrobial resistance phenotypes, and preceding COVID-19 infection had significant impacts on the progression of HABP to bloodstream infection and 28-day ACM in infected patients.
논문정보
- Research article
- 2023년 06월 (BRIC 등록일 2023-07-11)
- 국내 연구진
- 의약학 > 응용의학
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