title: The difference in clinical presentations between healthcare-associated and community-acquired pneumonia in university-affiliated hospital in Korea.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Hangang-ro 3-ga, Yongsan-gu, Seoul 140-757, Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Jeon
authors.forename: Sung-Gun
authors.initials: SG
authors.lastname: Cho
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Shin
authors.forename: Jae Yeol
authors.initials: JY
authors.lastname: Kim
authors.forename: In Won
authors.initials: IW
authors.lastname: Park
authors.forename: Byoung Whui
authors.initials: BW
authors.lastname: Choi
authors.forename: Jae Chol
authors.initials: JC
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis / Q000188:drug therapy; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents