Original Research Article
Year: 2020 | Month: April-June | Volume: 5 | Issue: 2 | Pages: 41-48
Clinico-Bacteriological Profile and Prognostic Factors of Hospital Acquired Pneumonia in Central Kerala
Divya C Varghese1, Dhwani Gopinath2, N Suhail3
1Senior Resident, 2Assistant Professor, 3Professor,
Department of Pulmonary Medicine, MES Medical College, Perinthalmanna, Malappuram, Kerala, India.
Corresponding Author: Dhwani Gopinath
ABSTRACT
Background. Hospital Acquired Pneumonia (HAP) is the second most common hospital acquired infection and a leading cause of mortality in spite of latest diagnostic and management modalities. HAP is defined as pneumonia occurring 48 hours after hospital admission which was not incubating at the time of admission. Early onset HAP occurs within first two to four days of admission and late HAP occurs five or more days after admission.
Method. This was a hospital based longitudinal study. Fifty patients admitted in our tertiary hospital who developed HAP were included in study based on ATS/IDSA 2016 HAP guidelines and an attempt was made to study clinical and bacteriological profile as well as outcome of these patients with factors affecting the outcome. Statistical analysis included descriptive statistics, chi-square test and Fisher exact test using SPSS statistical software version 23.
Result. Male gender and age group more than sixty were found more predisposed to HAP. However both did not carry any significant association with outcome. Overall mortality in the study was 44%. Significant association with outcome was found with diabetic status, prior intravenous antibiotics use, bilateral infiltrates in chest X ray, prolonged hospital stay and septic shock. Contrary to expectations, no significant association was found between mechanical ventilation and outcome. Most common organism isolated was K.pneumoniae.
Conclusion. Assessing risk factors help us in prognosticating HAP. Surveillance of HAP and knowing the suspect organism is of paramount importance in deciding empirical therapy for HAP patients and antibiotics should always be used judiciously.
Keywords: Hospital Acquired Pneumonia, hospital acquired infections, antibiotics, K.pneumoniae, outcome