HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Sopena, N. Search for Related Content PubMed PubMed Citation Articles by Sopena, N.

Multicenter Study of Hospital-Acquired Pneumonia in Non-ICU Patients^*

Nieves Sopena, MD, PhD and Miquel Sabrià, MD, PhD; the Neunos 2000 Study Group

^* From the Infectious Diseases Unit, University Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain. A list of Neunos 2000 Study Group members is given in the ^Appendix.

Correspondence to: Nieves Sopena, MD, PhD, Unitat de Malalties Infeccioses. Hospital Universitari Germans Trias i Pujol, C/Canyet s/n, Badalona CP 08916 (Barcelona), Spain; e-mail: nsopena{at}ns.hugtip.scs.es

Study objective: To know the incidence, epidemiology, etiology, and outcome of hospital-acquired pneumonia (HAP) in non-ICUs adult patients.

Setting: Twelve Spanish teaching hospitals.

Interventions: From April 1999 to November 2000, non-ICU HAP was prospectively studied by active, bimonthly 1-week surveillance. Epidemiologic data, etiology, and evolution of pneumonia were recorded. Blood and sputum cultures and Legionella pneumophila and Streptococcus pneumoniae urinary antigen tests were performed.

Results: We included 186 patients, with complete data available in 165 patients (70.3% male gender; mean age, 63.7 ± 16.9 years [ ± SD]) The mean incidence of HAP was 3 ± 1.4 cases/1,000 hospital admissions. Most patients (64.2%) were in medical wards, had severe underlying diseases (66.6%), and had a hospital stay > 5 days (76.4%). Blood cultures were performed in 139 patients (84.2%), sputum cultures were performed in 89 patients (53.9%), and urinary antigen detection was performed in 123 patients (74.5%). An etiologic diagnosis was obtained in 60 cases (36.4%), and 31 were definitive. The most frequent etiologies were S pneumoniae (16 cases, 14 definitive), L pneumophila (7 cases, 7 definitive), Aspergillus sp (7 cases, 3 definitive), Pseudomonas aeruginosa (7 cases, 2 definitive), and several Enterobacteriaceae (8 cases, 4 definitive). Clinical complications occurred in 52.1% of the cases, and mortality was 26% (13.9% attributed to pneumonia).

Conclusions: Non-ICU HAP is an important cause of hospital morbidity, observed most frequently in medical wards and elderly patients with severe underlying diseases. In this setting, S pneumoniae and Legionella sp should be considered in addition to other nosocomial pathogens; urinary antigen detection is useful in determining the prevalence of these microorganisms.

Key Words: hospital-acquired pneumonia • ICU • Legionella pneumonia • Legionnaires’ disease • nosocomial infection

This article has been cited by other articles:

				J. Carratala, A. Mykietiuk, N. Fernandez-Sabe, C. Suarez, J. Dorca, R. Verdaguer, F. Manresa, and F. Gudiol Health Care-Associated Pneumonia Requiring Hospital Admission: Epidemiology, Antibiotic Therapy, and Clinical Outcomes Arch Intern Med, July 9, 2007; 167(13): 1393 - 1399. [Abstract] [Full Text] [PDF]

				V. Thomas, K. Herrera-Rimann, D. S. Blanc, and G. Greub Biodiversity of Amoebae and Amoeba-Resisting Bacteria in a Hospital Water Network Appl. Envir. Microbiol., April 1, 2006; 72(4): 2428 - 2438. [Abstract] [Full Text] [PDF]

				A. Torres Implementation of Guidelines on Hospital-Acquired Pneumonia Chest, October 1, 2005; 128(4): 1900 - 1802. [Full Text] [PDF]