Nosocomial pneumonias – Retrospective study

Abstract

Nosocomial Pneumonias are the second most prevalent nosocomial infections. Assessing local risk factors for multidrug-resistant
microorganisms is essential for an adequate empirical antibiotic
therapy. The authors present a retrospective study based on the
review of nosocomial pneumonia cases through their clinical
files for a period of one year. A total of 168 cases were identified
(73.8% Healthcare-Associated Pneumonias – HCAP; 22.6%
Hospital Acquired Pneumonias – HAP; and 3.6% Ventilation-
-Associated Pneumonias). Empirical antibiotics directed against
classical “community bacteria” were used in 69.6% of the cases;
36.7% of these had to be changed later. A pathogen was identified
in 43.4% of the cases in which an etiological investigation was
carried out. 38.9% of the respiratory secretions cultures were
positive. The most prevalent microorganism was Staphylococcus
aureus. Methicillin-resistant Staphylococcus aureus accounted
for 13.9% of all nosocomial pneumonias in which an etiological
investigation was carried out. It seems there is a higher risk of
multidrug-resistant microorganisms in the subgroup of HCAP with
an admission less than 90 days before and in the subgroup of
late-onset HAP. The 30 day mortality rate was 46%. This study
has the limitation of being retrospective. It served as a starting
point for a prospective investigation that is now being performed.