[Hospital acquired pneumonia--analysis of frequency and etiology in Polish hospitals in 1998].
Hospital-acquired pneumonia (HAP) is one of the most frequently occurring hospital infections in the world. This study describes the incidence of HAP in Poland, as well as the specific risk factors leading to this type of infection in Polish hospitals; including those of patient age, length of hospitalization, and use of mechanical ventilation. The epidemiology of HAP as well as treatment resistance of various causal organisms was studied. Data for this study was acquired from the Registry of Hospital-acquired Infectious Diseases for the year 1998. Out of 329,608 hospital-acquired infections in all patients except newborns, 920 were found to be HAP. This study showed that of every 1000 hospital admissions three patients developed HAP (0.3%). Death occurred in 260 of 920 HAP cases or 30%; and HAP found to be the direct cause of death in 66 of the 260 cases (25%). The greatest incidence of HAP was found to occur in patients older than 75 years, was directly related to the length of hospital stay, and was higher in patients on mechanical ventilation longer than 10 days. The most frequently isolated causal agents were the Gram-negative rods (Pseudomonas aeruginosa, Acinetobacter sp., Klebsiella sp., Enterobacter sp.), and Staphylococcus aureus. Streptococcus pneumoniae and Haemophilus influenzae were found in only 2% and 4% of cases, respectively, and thus were the least likely causes of HAP in this population. It was found that the percentage of methicillin-resistant strains of Staphylococcus aureus was very high (55% to 60%); vancomycin-resistant enterococci were only found in patients who did not undergo surgery. The isolated strains of Pseudomonas aeruginosa showed marked resistance to chinolones (58-76%) and to imipen (approximately 20%). In the Enterobacteriaceae family, Klebsiella sp. was found to be resistant to third-generation cephalosporins (56-73%) and Enterobacter sp. resistant in 55% to 81% of the isolates.
Pietrzyk
A
A
Katedra Mikrobiologii Collegium Medicum UJ.
Wójkowska-Mach
J
J
Bulanda
M
M
Heczko
P B
PB
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D006801:Humans; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000382:microbiology*; D011044:Poland / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D015996:Survival Rate