6 269

Cited 12 times in

Validation of a scoring tool to predict drug-resistant pathogens in hospitalised pneumonia patients

Authors
 Park, S. C.  ;  Kim, E. Y.  ;  Kang, Y. A.  ;  Park, M. S.  ;  Kim, Y. S.  ;  Kim, S. K.  ;  Chang, J.  ;  Jung, J. Y. 
Citation
 INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol.17(5) : 704-709, 2013 
Journal Title
 INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE 
ISSN
 1027-3719 
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use* ; Area Under Curve ; Chi-Square Distribution ; Cross Infection/diagnosis ; Cross Infection/drug therapy* ; Cross Infection/microbiology* ; Cross Infection/transmission ; Decision Support Techniques* ; Drug Resistance, Bacterial* ; Female ; Humans ; Inpatients* ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Multivariate Analysis ; Pneumonia, Bacterial/diagnosis ; Pneumonia, Bacterial/drug therapy* ; Pneumonia, Bacterial/microbiology* ; Pneumonia, Bacterial/transmission ; Predictive Value of Tests ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Failure ; Unnecessary Procedures
Keywords
health care ; prediction ; risk scoring
Abstract
BACKGROUND: Health care-associated pneumonia (HCAP) affects a heterogeneous group of patients in frequent contact with health care systems. However, HCAP criteria poorly predict infection with drug-resistant (DR) pathogens. OBJECTIVE: To validate our previously reported risk-scoring model (predictive of DR pathogen infection) in patients admitted to hospital with pneumonia. DESIGN: We evaluated 580 patients admitted with culture-positive bacterial pneumonia. We identified risk factors, evaluated the risk-scoring model's capacity to predict infection by DR pathogens and compared the model's diagnostic accuracy with that of current HCAP criteria. RESULTS: DR pathogens were observed in 227/580 patients (39.1%). Of 269 HCAP patients, 153 (56.9%) were infected with DR pathogens. Overtreatment was more common in HCAP than in community-acquired pneumonia (58.7% vs. 41.2%, P < 0.001). Recent hospitalisation, admission from a long-term care facility, recent antibiotic treatment and tube feeding were independently associated with DR pathogens. For pathogen prediction, the risk-scoring model showed better diagnostic accuracy than HCAP criteria (area under receiver operating-characteristic curve = 0.723 vs. 0.673, P < 0.001). CONCLUSION: According to current HCAP criteria, half of the HCAP patients were treated unnecessarily with broad-spectrum antibiotics. Risk scoring by stratifying risk factors could improve the identification of patients likely to be infected with DR pathogens.
Full Text
http://www.ingentaconnect.com/content/iuatld/ijtld/2013/00000017/00000005/art00025?token=00541b670bae23ebc967e442f2067212376674470232b6d7b6c72687627502b333e3568263c2b55a86d6
DOI
10.5588/ijtld.12.0723
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Seon Cheol(박선철)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87346
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse