Tuberc Respir Dis > Accepted Articles
Epidemiology of HAP/VAP in Korea
DOI: https://doi.org/10.4046/trd.2021.0018    [Accepted]
Published online June 4, 2021.
Characteristics, management, and clinical outcomes of patients with hospital-acquired and ventilator-associated pneumonia: a multicenter cohort study in Korea
Ryoung-Eun Ko1, Kyung Hoon Min2, Sang-Bum Hong3, Ae-Rin Baek4, Hyun-Kyung Lee5, Woo Hyun Cho6, Changhwan Kim7, Youjin Chang8, Sung-Soon Lee9, Jee Youn Oh2, Heung Bum Lee10, Soohyun Bae11, Jae Young Moon12, Kwang Ha Yoo13, Kyeongman Jeon1,14, on behalf of the Korean HAP/VAP Study Group
1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
3Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
4Devision of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchun hyang University Bucheon Hospital, Bucheon, Korea
5Department of Internal Medicinn, Division of pulmonology, allergy and critical care medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
6Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
7Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
9Division of Pulmonary and Critical Care Medicine, Departmen of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea
10Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School, Jeonju, Korea
11Deppartmen of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
12Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea
13Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
14Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence:  Kyeongman Jeon,
Email: kjeon@skku.edu
Received: 25 January 2021   • Revised: 14 April 2021   • Accepted: 2 June 2021
*Ryoung-Eun Ko and Kyung Hoon Min contributed equally to this study as co-first authors.
Abstract
Background
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but domestic epidemiological data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of HAP/VAP in Korea.
Methods
This study is a multicenter retrospective cohort study. A total of 206,372 adult hospitalized patients at one of the 13 participating tertiary hospitals in Korea during a six-month period were screened for eligibility. Among these, patients diagnosed with HAP/VAP based on the IDSA/ATS definition for HAP/VAP were included in the study.
Results
Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients among whom 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. The majority of patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 (40.1%) patients and multidrug resistant (MDR) pathogens were isolated in 138 patients in which the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 (28.2%) patients with HAP required additional ICU care. Hospital mortality was 28.1% in our cohort. Among the 378 patients who survived, 54.2% were discharged home and 45.8% were transferred to other hospitals or facilities.
Conclusion
This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1000 patients. Patients with HAP/VAP from tertiary hospitals in Korea were elderly, had a risk of aspiration, and were often referred to step-down centers.
Key Words: healthcare-associated pneumonia, ventilator-associated pneumonia, epidemiology, mortality, Korea


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