[Hospitalized nursing home-acquired pneumonia--comparison with community-acquired pneumonia in older adults].
Nursing home-acquired pneumonia (NHAP) is a frequent cause of hospital admission and death among residents of long-term care facilities. We studied consecutive patients with NHAP who were admitted to our 358-bed acute care hospital from 2004 to 2007. Patients with NHAP (n = 147) were significantly older (85.8 +/- 8.0 years vs. 80.2 +/- 8.2 years); predominantly female (57.1% vs. 41.5%); had higher severity (the 2005 Japanese Respiratory Society guidelines A-DROP score: 2.5 +/- 1.1 vs. 2.1 +/- 1.2) and a higher mortality (10.4% vs. 5.8%); had a longer median length of hospital stay (17 days vs. 15 days) than elderly patients with community-acquired pneumonia (n = 545). Cerebrovascular disorders (31.3% vs. 14.1%), dementia (59.2% vs. 22.9%) and feeding tube placement (19.0% vs. 6.4%), which were associated with aspiration, were more common and bronchial asthma (0.7% vs. 8.8%) and COPD (4.1% vs. 19.8%) less common among those with NHAP. Although Methicillin-resistant Staphylococcus aureus (MRSA) was more frequently isolated from the sputa of the NHAP group (23.1% vs. 9.4%), Streptococcus pneumoniae was the most important causative agent by microbial investigations, including blood culture and urinary antigen testing in addition to sputum examination.
Tani
Shigenori
S
Tomioka
Hiromi
H
Kaneda
Toshihiko
T
Kubota
Mio
M
Kaneko
Masahiro
M
Fujii
Hiroshi
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology* / Q000382:microbiology; D012720:Severity of Illness Index; D012737:Sex Factors; D013296:Streptococcus pneumoniae / Q000302:isolation & purification