The Importance of Pathogen Identification in the Success of Treatment of Hospital Acquired Pneumonias

Ebru Cakir Edis, Osman Nuri Hatipoglu, İlker Yilmam, Alper Eker, Ozlem Tansel, Necdet Sut
2010 Turkish Thoracic Journal  
Objective: The aim of this study was to determine the effects of identification of the pathogens and specific and appropriate treatments, and the success of these treatments for subjects who acquired HAP non-ICU. Material and Method: The analyzed data was obtained from the records of 154 consecutive HAP patients who acquired pneumonia non-ICU. We investigated whether the factor was identified, whether patients received a specific therapy according to the results of a culture antibiogram, and
more » ... antibiogram, and whether the patients received appropriate antibiotics therapy initially. Results: When the groups treated specifically (n=78) and empirically (n=76) were compared, there were no significant differences between the clinical success rates. The difference was not significant between the group given an appropriate antibiotherapy initially (n=42) and the group whose initial therapy was changed according to the culture antibiogram after the factor was found (n=36). When the group given appropriate initial antibiotherapy (n=42) was compared with all the other patients (n=112), the difference between the clinical success rates was not significant. The most remarkable result of the study was the success rate being significantly higher in the group in which the pathogen could not be identified (n=66) compared with the group in (n=88) which the pathogen was identified (p=0.022). Conclusion: The clinical success rate was low in microorganismcaused HAPs with a potential for drug resistance and having the characteristic of developing rapid resistance, such as Acinetobacter spp. and Pseudomonas spp, even though specific treatment was administered. These results indicate that the prevention of infections that occur with such microorganisms is more important than the treatment. (Tur Toraks Der 2010; 11: 155-9) ÖZET Amaç: Bu çal mada hastanemizde yo un bak m d nda geli en hastane kökenli pnömonili (HKP) olgularda etken tespit edilip edilememesinin, spesifik tedavi al p alamaman n, erken veya geç uygun antibiyoterapi alman n tedavi ba ar s na olan etkilerini saptamay amaçlad k. Sonuç: Acinetobacter spp. ve Pseudomonas spp. gibi çok ilaca direnç potansiyeli ta yan ve h zl direnç geli tirebilme özelli ine sahip mikroorganizmalarla olu an HKP'lerde spesifik tedavi verilse dahi klinik ba ar oranlar dü üktür. Bu sonuç, bu tip özelliklere sahip mikroorganizmalarla olu acak enfeksiyonlar önlemenin, tedaviden daha önemli oldu una i aret etmektedir. (Tur Toraks Der 2010; 11: 155-9) Anahtar sözcükler: Yo un bak m d hastane kökenli pnömoni, mikrobiyolojik etken, uygun antibiyoterapi, tedavi ba ar s Geli Tarihi: 13.
doi:10.5152/ttd.2010.25 fatcat:aq5mbmh5srdfxkx3hfhtptjd5u