Impact of microbiological samples in the hospital management of community-acquired, nursing home-acquired and hospital-acquired pneumonia in older patients

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• 作者：A. Putot ; J. Tetu ; S. Perrin ; H. Bailly…
• 刊名：European Journal of Clinical Microbiology & Infectious Diseases
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：35
• 期：3
• 页码：489-495
• 全文大小：267 KB
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• 作者单位：A. Putot (1)
  J. Tetu (2)
  S. Perrin (1)
  H. Bailly (1)
  L. Piroth (3)
  J.-F. Besancenot (4)
  B. Bonnotte (5)
  P. Chavanet (3)
  P. d’Athis (6)
  P.-E. Charles (7)
  H. Sordet-Guépet (1)
  P. Manckoundia (1) (8)
  
  1. Department of Geriatrics and Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon, France
  2. Department of Microbiology, University Hospital, Dijon, France
  3. Department of Infectious Diseases, University Hospital, Dijon, France
  4. Department of Internal Medicine 2, University Hospital, Dijon, France
  5. Department of Internal Medicine 1, University Hospital, Dijon, France
  6. Department of Biostatistics and Medical Computing, University Hospital, Dijon, France
  7. Medical Intensive Care Unit, University Hospital, Dijon, France
  8. Inserm/U1093 Motricity-Plasticity, University of Burgundy and Franche Comté, Dijon, France
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Medical Microbiology
  Internal Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1435-4373

文摘

We investigated the positivity rate, the detection rates for non-covered pathogens and the therapeutic impact of microbiological samples (MS) in community-acquired pneumonia (CAP), nursing home-acquired pneumonia (NHAP) and hospital-acquired pneumonia (HAP) in elderly hospitalised patients. Patients aged 75 years and over with pneumonia and hospitalised between 1/1/2013 and 30/6/2013 in the departments of medicine (5) and intensive care (1) of our university hospital were included. Microbiological findings, intra-hospital mortality and one-year mortality were recorded. Among the 217 patients included, there were 138 CAP, 56 NHAP and 23 HAP. MS were performed in 89.9, 91.1 and 95.6 % of CAP, NHAP and HAP, respectively. Microbiological diagnosis was made for 29, 11.8 and 27.3 % of patients for CAP, NHAP and HAP, respectively (p = 0.05). Non-covered pathogens were detected for 8 % of CAP, 2 % of NHAP and 13.6 % of HAP (p = 0.1). The antimicrobial spectrum was significantly more frequently reduced when the MS were positive (46.7 % vs. 10.8 % when MS were negative, p = 10−7). The MS positivity rate was significantly lower in NHAP than in CAP and HAP. MS revealed non-covered pathogens in only 2 % of NHAP. These results show the poor efficiency and weak clinical impact of MS in the management of pneumonia in hospitalised older patients and suggest that their use should be rationalised.