Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
J Infect Chemother. 2011 Jun;17(3):363-9. doi: 10.1007/s10156-010-0127-8. Epub 2010 Oct 8.
Healthcare-associated pneumonia (HCAP) is a newly identified condition, and epidemiologic studies in Japan are still limited. We retrospectively observed patients with HCAP and community-acquired pneumonia (CAP) who were hospitalized between December 2004 and March 2005, and compared their disease characteristics. A total of 34 patients (14 with HCAP and 20 with CAP) were evaluated. Of the patients with HCAP, seven (50%) were hospitalized for at least 2 days in the preceding 90 days and five (35.7%) resided in a nursing home or extended care facility. Compared with patients with CAP, patients with HCAP were older, had more complications, including central nerve diseases, had greater disease severity, but lower serum albumin level. More methicillin-resistant Staphylococcus aureus, Pseudomonas spp., and anaerobes were isolated from patients with HCAP than from those with CAP. Conversely, more Streptococcus pneumoniae was detected and more penicillin was used in patients with CAP. This study provides additional evidence that HCAP should be distinguished from CAP and suggests the pathogenesis and therapeutic strategy for HCAP may be similar to those for hospital-acquired pneumonia.
医院获得性肺炎（HCAP）是一种新确定的病症，日本的流行病学研究仍然有限。我们回顾性观察了 2004 年 12 月至 2005 年 3 月期间住院的 HCAP 和社区获得性肺炎（CAP）患者，并比较了他们的疾病特征。共评估了 34 名患者（14 名 HCAP 和 20 名 CAP）。在 HCAP 患者中，有 7 名（50%）在过去 90 天内至少住院 2 天，5 名（35.7%）居住在疗养院或长期护理机构。与 CAP 患者相比，HCAP 患者年龄更大，合并症更多，包括中枢神经系统疾病，疾病严重程度更高，但血清白蛋白水平更低。从 HCAP 患者中分离出的耐甲氧西林金黄色葡萄球菌、假单胞菌属和厌氧菌比从 CAP 患者中分离出的更多。相反，在 CAP 患者中检测到更多的肺炎链球菌，并且使用了更多的青霉素。这项研究提供了额外的证据表明 HCAP 应与 CAP 区分开来，并表明 HCAP 的发病机制和治疗策略可能与医院获得性肺炎相似。
