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BMC Infect Dis. 2016 Aug 8;16:377. doi: 10.1186/s12879-016-1701-1.

Risk factors to predict drug-resistant pathogens in hemodialysis-associated pneumonia.

Author information

1
Division of Thoracic Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
2
Oriental Institute of Technology, New Taipei City, Taiwan.
3
Division of Thoracic Medicine, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei City, Taiwan. haochienwang@gmail.com.

Abstract

BACKGROUND:

After the concept of healthcare associated pneumonia (HCAP) was introduced in 2005 by the American Thoracic Society/Infectious Disease Society of America (ATS/IDSA), pneumonia in hemodialysis patients has been classified as HCAP. Even though there are several risk factors and scoring systems of drug-resistant pathogens (DRPs) in HCAP, the risk factors for DRPs in hemodialysis-associated pneumonia are unclear.

METHODS:

Patients who were admitted to our tertiary care hospital from January 2005 to December 2010 were screened by a discharge diagnosis of pneumonia. Patients were enrolled if they fulfilled the definition of HCAP according to the 2005 ATS/IDSA guidelines.

RESULTS:

A total of 530 subjects were diagnosed with HCAP, of whom 48 (9.1 %) received regular hemodialysis (HD group) and the other 482 did not (non-HD group). The most common pathogens in HD group were Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus (MRSA). There was a similar distribution of Gram-negative bacilli infections between the two groups except for Haemophilus influenzae and Citrobacter species. The incidence of DRPs was not significantly different between the two groups (HD vs. non-HD, 35.4 vs. 39.2 %, p = 0.607). Wound care, severe pneumonia and an age of more than 70 years were significant risk factors for DRPs. The area under the operating cure of predicting DRPs was 0.727 (0.575-0.879, p = 0.01).

CONCLUSION:

P. aeruginosa and MRSA were the most important pathogens in hemodialysis-associated pneumonia. Wound care, severe pneumonia and old age were significant risk factors for DRPs.

KEYWORDS:

Drug resistant pathogens; Hemodialysis; Pneumonia

PMID:
27502599
PMCID:
PMC4977861
DOI:
10.1186/s12879-016-1701-1
[Indexed for MEDLINE]
Free PMC Article

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