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首页> 外文期刊>Respirology : >Clinical features of healthcare-associated pneumonia (HCAP) in a Japanese community hospital: comparisons among nursing home-acquired pneumonia (NHAP), HCAP other than NHAP, and community-acquired pneumonia.
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Clinical features of healthcare-associated pneumonia (HCAP) in a Japanese community hospital: comparisons among nursing home-acquired pneumonia (NHAP), HCAP other than NHAP, and community-acquired pneumonia.

机译：日本社区医院的医疗保健相关性肺炎（HCAP）的临床特征：养老院获得性肺炎（NHAP），NHAP以外的HCAP和社区获得性肺炎的比较。

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BACKGROUND AND OBJECTIVE: More than 100000 Japanese die of pneumonia every year. The number of people residing in nursing homes is increasing with the ageing of the population. In 2005, the American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) published important guidelines for the management of healthcare-associated pneumonia (HCAP). In Japan, however, the optimum strategy for management of HCAP is still unclear. The purpose of this study was to clarify the clinical features of patients with HCAP. METHODS: Patients (n = 202) who were consecutively admitted with a diagnosis of acute pneumonia between October 2007 and September 2009 were retrospectively evaluated. Using the ATS/IDSA guidelines, patients were divided into three groups: a community-acquired pneumonia (CAP) group (n = 123), a nursing home-acquired pneumonia (NHAP) group (n = 46) and a HCAP other than NHAP (O-HCAP) group (n = 33). These groups were then compared with respect to laboratory data, microbiological findings and mortality. RESULTS: Thirty-day mortality in the NHAP group (10.9%) tended to be higher than that in the CAP group (3.3%) or the O-HCAP group (0%). The pathogens most frequently identified were Streptococcus pneumoniae and Haemophilus influenzae in the CAP group, methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae in the NHAP group, and S. pneumoniae and K. pneumoniae in the O-HCAP group. CONCLUSIONS: The NHAP group was clinically different from the O-HCAP group, based on bacteriological examination and mortality rates. In order to accurately diagnose, and formulate optimum treatment strategies for Japanese patients, the categories of HCAP, as specified in the ATS/IDSA guidelines, should not be applied directly either to patients with NHAP or those with O-HCAP.
机译：背景与目的：每年有超过10万的日本人死于肺炎。随着人口老龄化，住在疗养院的人数正在增加。 2005年，美国美国胸腔学会/传染病学会（ATS / IDSA）发布了与医疗保健相关的肺炎（HCAP）管理的重要指南。但是，在日本，HCAP管理的最佳策略仍不清楚。本研究的目的是阐明HCAP患者的临床特征。方法：回顾性分析2007年10月至2009年9月期间连续入院诊断为急性肺炎的患者（n = 202）。根据ATS / IDSA指南，将患者分为三组：社区获得性肺炎（CAP）组（n = 123），疗养院获得性肺炎（NHAP）组（n = 46）和除NHAP之外的HCAP （O-HCAP）组（n = 33）。然后将这些组的实验室数据，微生物学发现和死亡率进行比较。结果：NHAP组的30天死亡率（10.9％）倾向于高于CAP组（3.3％）或O-HCAP组（0％）。 CAP组最常见的病原体是肺炎链球菌和流感嗜血杆菌，NHAP组是耐甲氧西林金黄色葡萄球菌和肺炎克雷伯菌，O-HCAP组是肺炎链球菌和肺炎克雷伯菌。结论：基于细菌学检查和死亡率，NHAP组在临床上与O-HCAP组不同。为了准确诊断和制定针对日本患者的最佳治疗策略，ATS / IDSA指南中规定的HCAP类别不应直接应用于NHAP或O-HCAP患者。

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