Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization

Abstract

Introduction: The recently introduced concept of health care-associated pneumonia (HCAP), referring to patients with frequent healthcare contacts and at higher risk of contracting resistant pathogens is controversial.

Materials and Methods: A prospective study comparing patients with HCAP and community-acquired pneumonia (CAP) in the our center. The primary outcome was 30 day mortality.

Results: A total of the 169 patients HCAP 36 (21.3%); CAP 133 (78.7%) were evaluated. HCAP patients were older than patients with CAP [median age was 72.5 (43-96), 60.0 (18-91) years p< 0.05]. The most common Klebsiella pneumoniae (16.6%) and Pseudomonas aeruginosa (8.3%) were gram-negative bacteria in the SBIP group; In the TGP group, gram-positive bacteria were more frequently isolated. Polymicrobial agents (22.2% vs. 3.7% p< 0.05) and MDR pathogens (57.1% vs. 24% p< 0.05) were more common in patients with HCAP. Mortality rate (22.2% vs. 6% p< 0.05) was also higher in HCAP more than CAP.

Conclusion: HCAP was common among patients with pneumonia requiring hospitalization and mortality rate was high. The patients with HCAP were different from CAP in terms of demographic and clinical features, etiology, outcome.