Tatlı Kış T, Yıldırım S, Tamay Tatlı F, Ok MM, Biçmen C, Kıraklı C
Journal of Basic and Clinical Health Sciences - 2025;9(3):628-634
Purpose: Hospital-acquired pneumonia and ventilator-associated pneumonia are significant public health problems worldwide. The aim of this study was to determine the etiological pathogens, susceptibility distribution, and parameters that may indicate poor prognosis in patients diagnosed with hospital-acquired pneumonia and followed up in the intensive care unit. Materials and Methods: This study was designed as a retrospective cohort study. Demographic characteristics, causative microorganisms, susceptibility profiles of these pathogens, and 28-day mortality data (all-cause) of patients diagnosed with hospital-acquired pneumonia and ventilator-associated pneumonia were reviewed from patient files. At the end of the 28-day period, patients were divided into survivor and non-survivor groups based on their survival status. Clinical parameters were compared between the two groups. Results: This study included 142 patients diagnosed with hospital-acquired pneumonia. Of these, 102 (71.8%) patients were diagnosed with ventilator-associated pneumonia. The median age of the cohort was 72 years (IQR 65-79), and 73.9% were male. The frequency of concomitant malignancy (43.0% vs 25.0%, p=0.029), white blood cell values at the onset of pneumonia [median 15.2 (IQR 9.8-20.9) vs 11.9 (IQR 8.6-14.4), p=0.010], procalcitonin levels [median 0.9 (IQR 0.3-5.3) vs 0.3 (IQR 0.1-1.4) p=0.003], and the frequency of bloodstream infections secondary to pneumonia (39.5% vs 8.9% p<0.001) were found to be statistically significantly higher in the non-survivor group compared to the survivor group. The most frequently isolated pathogen was Klebsiella pneumoniae [66/142 (46.5%)], followed by Pseudomonas aeruginosa [28/142 (19.7%)] and Acinetobacter baumannii [16/142 (11.3%)]. The highest carbapenem resistance was detected in Klebsiella pneumoniae (95.54%). The 28-day mortality rate was 60.6%. In multivariate analysis, bloodstream infection secondary to pneumonia was independently associated with 28-day mortality (OR: 6.98, 95% CI: 2.37-20.54, p<0.001). Conclusion: Mortality rates are high in hospital-acquired pneumonia and ventilator-associated pneumonia patients followed in the ICU. The development of bacteremia secondary to pneumonia is an independent risk factor for mortality.
