Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea

  • Ko, Ryoung-Eun (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Min, Kyung Hoon (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Hong, Sang-Bum (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Baek, Ae-Rin (Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchun hyang University Bucheon Hospital) ;
  • Lee, Hyun-Kyung (Department of Internal Medicinn, Division of Pulmonology, Allergy and Critical Care Medicine, Busan Paik Hospital, Inje University College of Medicine) ;
  • Cho, Woo Hyun (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital) ;
  • Kim, Changhwan (Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Chang, Youjin (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital) ;
  • Lee, Sung-Soon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Oh, Jee Youn (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Lee, Heung Bum (Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School) ;
  • Bae, Soohyun (Department of Internal Medicine, Ulsan University Hospital) ;
  • Moon, Jae Young (Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital) ;
  • Yoo, Kwang Ha (Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Jeon, Kyeongman (Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2021.01.25
  • Accepted : 2021.06.02
  • Published : 2021.10.31
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Abstract

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

Keywords

Acknowledgement

This study was funded by the 2019 Research Grant (2019-E2808-00), which was received from the Korean Disease Control and Prevention Agency.

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