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Title: High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia
Authors: Doo Ryeon Chung
Jae Hoon Song
So Hyun Kim
Visanu Thamlikitkul
Shao Guang Huang
Hui Wang
Thomas Man Kit So
Rohani M.D. Yasin
Po Ren Hsueh
Celia C. Carlos
Li Yang Hsu
Latre Buntaran
M. K. Lalitha
Min Ja Kim
Jun Yong Choi
Sang Il Kim
Kwan Soo Ko
Cheol In Kang
Kyong Ran Peck
SungKyunKwan University, School of Medicine
Asia Pacific Foundation for Infectious Diseases
Mahidol University
Ruijin Hospital
Peking Union Medical College
Princess Margaret Hospital Hong Kong
Institute for Medical Research Kuala Lumpur
National Taiwan University Hospital
National University Hospital, Singapore
Harapan Kita Hospital
Madras Medical Mission
Korea University, College of Medicine
Yonsei University College of Medicine
The Catholic University of Korea
Peking University
Keywords: Medicine
Issue Date: 15-Dec-2011
Citation: American Journal of Respiratory and Critical Care Medicine. Vol.184, No.12 (2011), 1409-1417
Abstract: Rationale: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality. Increasing antimicrobial resistance has aroused the concern of the failure of antibiotic treatment. Objectives: To determine the distribution of the bacterial isolates of HAP and VAP, their antimicrobial resistance patterns, and impact of discordant antibiotic therapy on clinical outcome in Asian countries Methods: A prospective surveillance study was conducted in 73 hospitals in 10 Asian countries from 2008-2009. A total of 2,554 cases with HAP or VAP in adults were enrolled and 2,445 bacterial isolates were collected from 1,897 cases. Clinical characteristics and antimicrobial resistance profiles were analyzed. Measurement and Main Results: Major bacterial isolates from HAP and VAP cases in Asian countries were Acinetobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae. Imipenem resistance rates of Acinetobacter and P. aeruginosa were 67.3% and 27.2%, respectively. Multidrug-resistant rates were 82% and 42.8%, and extensively drug-resistant rates were 51.1% and 4.9%. Multidrug-resistant rate of K. pneumoniae was 44.7%. Oxacillin resistance rate of S. aureus was 82.1%. All-cause mortality rate was 38.9%. Discordant initial empirical antimicrobial therapy increased the likelihood of pneumonia-related mortality (odds ratio, 1.542; 95% confidence interval, 1.127-2.110). Conclusions: Acinetobacter spp., P. aeruginosa, S. aureus, and K. pneumoniae are the most frequent isolates from adults with HAPor VAP in Asian countries. These isolates arehighly resistant tomajor antimicrobial agents, which could limit the therapeutic options in the clinical practice. Discordant initial empirical antimicrobial therapy significantly increases the likelihood of pneumonia-relatedmortality. Copyright © 2011 by the American Thoracic Society.
ISSN: 15354970
Appears in Collections:Scopus 2011-2015

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