Retrospective analysis of risk factors and prognosis in non-ventilated patients with nosocomial pneumonia
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Although nosocomial pneumonia in non-ventilated patients continues to be frequent and have high mortality rates, knowledge of the associated risk and prognostic factors is still limited. This retrospective study was designed to analyze epidemiological characteristics, risk and prognostic factors in patients with nosocomial pneumonia admitted to a hospital internal medicine department. Data on epidemiological, clinical and microbiological factors as well as diagnosis and clinical course were obtained from the medical records of 104 patients diagnosed with nosocomial pneumonia, according to Centers for Disease Control criteria, and from 104 control subjects. The incidence of nosocomial pneumonia was 18.8 per 1000 admissions. Risk factors significantly associated with contracting the disease were female sex, hospital stay longer than 14 days, other admission in the previous month and use of antibiotics during the previous six weeks. The most frequent underlying diseases were cardiorespiratory in nature (59.4 %). Prognostic factors significantly associated with increased mortality were serious underlying disease, initially critical clinical status, severe and moderate respiratory insufficiency and bilateral radiological signs. More epidemiological data are needed to improve the diagnosis, treatment and prevention of nosocomial pneumonia.
- Pennington JE: Nosocomial pneumonia. Current Opinion in Infectious Diseases 1992, 5: 505–511.
- Grupo de Trabajo EPINCAT: Prevalencia de las infecciones nosocomiales en los hospitales españoles durante 1992 (EPINE). Ed Grafimed Publicidad, Barcelona, 1993.
- Louie M, Parker S, Sekla L, Nicolle LE: Nosocomial pneumonia in a Canadian tertiary care center: a prospective surveillance study. Infection Control and Hospital Epidemiology 1991, 12: 356–363.
- Celis R, Torres A, Gatell JM, Almela M, Rodriguez Roisin R, Agusti-Vidal A: Nosocomial pneumonia: a multivariate analysis of risk and prognosis. Chest 1988, 93: 318–324.
- McDonald AM, Dietsche L, Litsche N, Spurgas R, Ledgerwood R, Subitha CJ, LaForce FM: A retrospective study of nosocomial pneumonia at a long-term care facility. American Journal of Infection Control 1992, 20: 234–238. CrossRef
- Garnes JS, Jarvis WR, Emori TG, Horan TH, Hughes JM: CDC definitions for nosocomial infections 1988. American Journal of Infection Control 1988, 16: 128–140.
- McCabe WR, Jackson GG: Gram negative bacteremia. I. Etiology and ecology. Archives of Internal Medicine 1962, 110: 847–855.
- Winston DJ, Murphy W, Young LS: Piperacillin therapy for serious bacterial infections. American Journal of Medicine 1980, 69: 255–261. CrossRef
- Gómez J, Baños V, Ruiz J, Herrero F, Pérez M, Pretel L, Canteras M, Valdés M: Clinical significance of anaerobic bacteremias in a general hospital. A prospective study from 1988 to 1992. Clinical Investigator 1993, 71: 595–599.
- Gómez J, Ruiz Gómez J, Herrero F, Molina-Boix M, Baños V, Valdés M: Elección razonada del uso de antibióticos en la práctica clínica. Enfermedades Infecciosas y Microbiología Clínica 1993, 11: 214–220.
- Chow AW, Hall CB, Klein JO, Kammer RB, Meyer RD, Remington JS: Evaluation of new anti-infective drugs for the treatment of respiratory tract infections. Clinical Infectious Diseases 1992, 15, Supplement 1: S62-S88.
- Manresa F: Rapid clinical diagnostic methods in respiratory infections. Current Opinion in Infectious Diseases 1989, 2: 536–540.
- Garcia Rio F, Prados C, Talaver IG, Casadevall J, Gomez L, Alvarez Sala R, Diaz S, Villasante C: Problemas en el diagnóstico de las neumonias nosocomiales. Anales de Medicina Interna 1993, 10: 86–90.
- Hanson LC, Weber DJ, Rutala WA: Risk factors for nosocomial pneumonia in the elderly. American Journal of Medicine 1992, 92: 161–166. CrossRef
- Harkness GA, Bentley DW, Roghmann KJ: Risk factors for nosocomial pneumonia in the elderly. American Journal of Medicine 1990, 89: 457–463. CrossRef
- Carratala J, Gudiol F, Pallares R, Verdaguer R, Manresa F: Risk factors for endemic nosocomial Legionella pneumonia. American Journal of Respiratory and Critical Care Medicine 1994, 149: 625–629.
- Saenghirunvattana S, Charoenpan P, Kiatboonsri S, Aeursudkij B: Nosocomial pneumonia: a comparison among normal and compromised hosts in Thailand. Journal of the Medical Association of Thailand 1992, 75: 26–29.
- Schleupner CJ, Cobb DK: A study of the etiologies and treatment of nosocomial pneumonia in a community-based teaching hospital. Infection Control and Hospital Epidemiology 1992, 13: 515–525.
- Unertl KE, Lenhart FP, Forst H, Peter K: Systemic antibiotic treatment of nosocomial pneumonia. Intensive Care Medicine 1992, 18, Supplement 1: 28–34.
- Fernández Guerrero M, Gudiol F, Rodriguez Torres A, Arnau C, Valdés L, Vallve C: Nosocomial pneumonia comparative multicentre trial between monotherapy with cefotaxime and treatment with antibiotic combinations. Infection 1991, 19, Supplement 6: 320–325.
- Gentry LO, Rodriguez Gomez G, Kohler RB, Khan FA, Rytel MW: Parenteral followed by oral ofloxacin for nosocomial pneumonia and community-acquired pneumonia requiring hospitalization. American Review of Respiratory Diseases 1992, 14: 531–535.
- Hartenauer U, Weilemann LS, Bodman KF, Ritzerfeld WW, Asmus S, Koch EM: Comparative clinical trial of ceftazidime and imipenem/cilastatin in patients with severe nosocomial pneumonia and septicaemia. Journal of Hospital Infection 1990, 15, Supplement A: 61–64.
- Gómez J, Esquinas A, Herrero F: Neumonias nosocomiales ¿Ceftazidima como tratamiento empírico inicial? Revista Española de Quimoterapia 1992, 5: 297–300.
- Rello J, Ausina V, Ricat M, Puzo C, Net A, Prats G: Nosocomial pneumonia in critically ill comatose patients: need for a differential therapeutic approach. European Respiratory Journal 1992, 51: 1249–1253.
- Scheld WM, Mandell GL: Nosocomial pneumonia pathogenesis and recent advances in diagnosis and therapy. Reviews of Infectious Diseases 1991, 13, Supplement 9: 5743–5751.
- Craven DE, Steger KA, Barber TW: Preventing nosocomial pneumonia: state of the art and perspectives for the 1990s. American Journal of Medicine 1991, 91, Supplement 3B: 44S-53S.
- Retrospective analysis of risk factors and prognosis in non-ventilated patients with nosocomial pneumonia
European Journal of Clinical Microbiology and Infectious Diseases
Volume 14, Issue 3 , pp 176-181
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Internal Medicine Service, Infectious Diseases Unit, Virgen de Arrixaca University Hospital, Plaza de la Cruz Roja, 30003, Murcia, Spain
- 2. Pneumology Section, Virgen de Arrixaca University Hospital, Plaza de la Cruz Roja, 30003, Murcia, Spain
- 3. Microbiology Section, Virgen de Arrixaca University Hospital, Plaza de la Cruz Roja, 30003, Murcia, Spain
- 4. Department of Biostatistics, School of Medicine, University of Murcia, 30100, Espinardo, Murcia, Spain
- 5. Department of Medicine, School of Medicine, University of Murcia, 30100, Espinardo, Murcia, Spain