THE EVALUATION OF HOSPITAL ASSOCIATED PNEUMONIA (HAP) CASES IN THE LAST FIVE YEARS (2012 - 2017) AT AFYON KOCATEPE UNIVERSITY MEDICAL FACULTY HOSPITAL
Journal Title: Kocatepe Medical Journal - Year 2023, Vol 24, Issue 3
Abstract
OBJECTIVE: This study was aimed to guide the appropriate empirical treatment, by determining the frequency of hospital acquired pneumonia (HAP) and Ventilator-associated pneumonia (VAP) in different parts of the hospital, the causative microorganisms and their antibiotic resistance patterns. MATERIAL AND METHODS: Patients aged ≥18 years who were hospitalized in Afyon Kocatepe University Hospital between January 2012 and December 2017 and who developed HAP and VAP during their follow-up were included in the study. Age, gender, hospitalization unit, presence of chronic disease, the relationship between pneumonia and ventilator, number of patients who developed mortality, characteristics of patients who developed mortality, and possible risk factors were recorded and evaluated. RESULTS: 405 (%65.5) of the patients were VAP, and 213 (%34.5) of patients were HAP. The mean age was 67.20±15.42 years. 240 (%38.8) of the patients were female, and 378 (%61.2) were male. The male gender had a statistically significant effect on the development of VAP and HAP (p=0.006). There was no chronic disease in 329 (%53.2) of the patients, and 289 (%46.8) had a chronic disease. The most common chronic diseases were respectively; Diabetes mellitus (DM) (%15.3), Hypertension (HT) (%12.6), and Chronic Obstructive Pulmonary Disease (COPD) (%7.6). The relationship between comorbidity and the development of VAP was found to be significant (p=0.003). HAP developed in 122 (%57.3) and VAP developed in 384 (%94.9) of the patients hospitalized in the intensive care units (ICU). HAP developed in 63 (%29.6) and VAP developed in 14 (%3.4) of the patients hospitalized in internal units. 28 (%13.1) of the patients who were hospitalized in surgical units developed HAP, and 7 (%1.7) of the patients developed VAP who hospitalized in surgical units. The incidence of HAP and VAP was found to be significantly higher in patients hospitalized in ICUs (p<0.001). The incidence of HAP and VAP was found to be significantly higher in patients who were hospitalized in ICUs (p<0.001). The causative agent could not be determined 161 (%75.5) of 213 patients in the HAP group, and 211 (%52.1) of 405 patients in the VAP group. The most frequently isolated microorganisms in HAP and VAP cases were; A.baumannii, K.pneumoniae, P.aeruginosa, E.coli, and methicillin-resistant Staphylococcus aureus (MRSA).Meropenem resistance was found in 103 (%97.2) and imipenem resistance in 105 (%99.1) A.baumannii strains. Mortalitydeveloped in 373 (%60.4) of the patients. Mortality was seen in297 (%48.1) of the VAP group and 76 (%12.3) of the HAP group. The mortality rate was higher in the VAP group (p<0.001). Male gender, mean age ≥60 years, comorbidity and ICU hospitalization were risk factors that increased mortality. No correlation was found between any of the causative microorganisms and thedevelopment of mortality. CONCLUSIONS: Measures should be increased to prevent the development of VAP in our institution because most of HAPs were in the VAP group in this retrospective study.
Authors and Affiliations
Merve TÜRKMEN, Neşe DEMİRTÜRK
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- EP ID EP722651
- DOI https://doi.org/10.18229/kocatepetip.1058851
- Views 44
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