Publication: High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia
Issued Date
2011-12-15
Resource Type
ISSN
15354970
1073449X
1073449X
Other identifier(s)
2-s2.0-84155171838
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Respiratory and Critical Care Medicine. Vol.184, No.12 (2011), 1409-1417
Suggested Citation
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 High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. American Journal of Respiratory and Critical Care Medicine. Vol.184, No.12 (2011), 1409-1417. doi:10.1164/rccm.201102-0349OC Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12152
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Title
High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia
Other Contributor(s)
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
Gokila
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
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
Gokila
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
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.