The differences in clinical characteristics between health care associated pneumonia and community acquired pneumonia in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To reveal the differences in clinical characteristics between health care associated pneumonia (HCAP) and community acquired pneumonia (CAP) in elderly patients.Methods A total of 282 elderly patients were evaluated,including 69 patients with HCAP (25.5％) and 213 with CAP (75.5％).A retrospective observational study was conducted.The baseline characteristics,comorbidities,pathogen distribution,antibiotics,and clinical outcomes between HCAP and CAP patients were compared.Results The incidence of chronic obstructive pulmonary diseases and cerebrovascular diseases were higher in HCAP group (49 cases,71.0％; 36 cases,52.2％) than in CAP group (93 cases,43.7％; 57 cases,26.8％) (x2 =15.598,15.229,all P＜0.001).The infection of Pseudomonas aeruginosa (29 cases,51.8％),Staphylococcus aureus (19cases,34.0％) and Acinetobacter baumannii (18 cases,32.1％) in HCAP group were more than in CAP group [(26 cases,27.7％),(12 cases,2.8％),(8 cases,8.5％),(x2 =8.796,9.586,13.678,all P＜0.05)],respectively.While the infection of Streptococcus pneumoniae (38 cases,40.4％) in CAP group was much more than in HCAP group (4 cases,7.1％)(x2 =19.283,P＜0.001).Initial inappropriate antibiotics treatment failure was more frequent in HCAP group (24 cases,34.8％) than in CAP group (37 cases,17.3％)(x2=9.321,P＜0.05).The mortality was higher in HCAP group (19 cases,27.5％) than in CAP group (29 cases,13.6％)(x2 =7.151,P＜0.05).Conclusions HCAP should be distinguished from CAP in elderly,which is helpful to choose appropriate empirical anti-infective regimen and improve the effect of HCAP treatment.