Background/Aims: Whether the causative organism influences the clinical course of pneumonia

Background/Aims: Whether the causative organism influences the clinical course of pneumonia in the intensive care unit (ICU) is controversial. re-intubation and tracheostomy were detected based on the identification of any pathogen. In sub-analyses according to the pneumonia classification the number of pathogens identified did not differ between pneumonia types and a higher incidence ABR-215062 of identified MDR pathogens was detected in the hospital-acquired pneumonia group than in the community-acquired or healthcare- acquired pneumonia groups. However the clinical outcomes of pneumonia according to identification status and type of pathogen did not differ significantly between the groups. Conclusions: Neither the causative micro-organism nor the existence of MDR pathogens in critically ill patients with pneumonia was associated with the clinical outcome of pneumonia including ICU mortality. This result was consistent regardless of the pneumonia classification. or methicillin-resistant (MRSA) is a risk factor for hospital mortality [6-8]. However one study reported that the pathogen classification or the existence of MDR pathogens does not affect the mortality rate after adjusting for the effect of antibiotics [9]. Although one study has reported the epidemiology and causative micro-organisms of pneumonia in Korea [10] the prognosis of pneumonia according to the causative micro-organism in the ICU is not well known. Thus in this study we elucidated the clinical manifestations and prognosis of patients with pneumonia according to ABR-215062 the causative pathogen in the medical ICU. METHODS Study design and participants A retrospective observational study was performed in the medical ICU of the Seoul National University Hospital between January 2011 and August 2011. We included patients with pneumonia treated in the medical ICU. Patients ABR-215062 were enrolled if they had pneumonia on ABR-215062 admission or developed pneumonia during their ICU stay. A total of 242 patients were admitted and treated in the medical ICU over the study period; in addition data from 102 patients with pneumonia were analyzed retrospectively. Pneumonia was clinically classified based on the American Thoracic Society/Infectious Disease Society of America guidelines [11 12 Relating to these recommendations healthcare-associated pneumonia (HCAP) was thought as pneumonia in virtually any individual admitted for an severe treatment medical center for ≥ 2 times within Rabbit Polyclonal to CNKSR1. 3 months from the disease; who resided inside a medical house or long-term treatment facility; who received recent intravenous antibiotic therapy wound or chemotherapy treatment within thirty days of onset of the existing disease; or who went to a medical center or hemodialysis center within thirty days. HAP was thought as pneumonia that created ≥ 48 hours after entrance. Community-acquired pneumonia (Cover) was thought as pneumonia that didn’t meet the HCAP and HAP requirements. The causative microorganisms were regarded as micro-organisms that were isolated from specimens including bloodstream bronchoalveolar lavage liquid bronchial clean and pleural effusion and which grew to greater threshold focus in quantitative ethnicities. Specimens acquired by endotracheal aspiration or in sputum expectorant had been evaluated as suitable using matters of white bloodstream cells and epithelial cells as well as the micro-organisms identified were considered the causative pathogen. Growth below the threshold was considered to be caused by colonization or contamination. and urinary antigen tests viral polymerase chain reaction and antigen tests were also used to identify the pathogens. Pathogens may have been confirmed in additional samples after a patient developed pneumonia but a secondary infection due to a hospital- or ICU-acquired pathogen was ruled out. Specimens sampled within 3 days after a patient developed pneumonia were considered significant. Empirical antibiotic regimens to treat pneumonia were reviewed and their response and relevance to subsequent changes in the antibiotic regimen were analyzed. The initial empirical antibiotic regimen was administered according to the American Thoracic Society/Infectious Disease Society of America guidelines [11 12 Initial non-responders to empirical antibiotics were defined as cases in which the initial antibiotic was changed due to expansion or a switch in the antibiotic spectrum due to persistence or worsening of.