SESSION TITLE: Respiratory Infections Posters II
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Identification of patients with drug-rersistant pathogenes at initial diagnosis is essential for traetment of pneumonia.The purpose of this study was to elucidate clinical features of community-aquired pneumonia(CAP) and to clarify risk factors for drug resistant pathogenes in patients with COPD.
METHODS: A prospective observational study was conducted in hospitalized patients with CAP at three centers in Azerbaijan republic.Pathogenes identified as not susceptible to ceftriaxone ,amoxicillin-clavulonic acid ,macrolides,and fluoroquinolones were defined as CAP drug-resistant pathogenes(CAP-DRPs).Microbilogic laboratories in all centers provided possible causative pathogenes,which were cultured in a semiquantitative manner from samples of sputum,tracheobronchial aspitates,bronchalveolar lavage fluid,and blood.Serologic tests were performed to detect antibodies against Mycoplasma pneumoniae and Chlamydophila pneumoniae.Legionella pneumophila serogroup I antigen in urine was tested by immonochromotography.
RESULTS: In total, 368 patients with CAP were analized.this observotional study was performed prospectively from January 15 ,2013 through december 25,2013 at one university hospital(a 500-beds),one institution hospital(a 300-beds) and one major community hospital(a 200-beds).All adult patients(>_20 yr) in whom pneumonia had developed during daily community living were included in the study.CAP-DRPs were found in 86(23.4%) patients with CAP.Independents risk factors for CAP-DRPs were almost identical in all three observational study centers.These included prior hospitalization(adjusted odds ratio[AOR],2.57;95% confidence interval[CI],1.45-3.89),previous antibiotic use (AOR),3.85;95% CI,2.14-5.69),use of gastric acid-supressive agents(AOR,2.75;95%CI 1.65-3.95).
CONCLUSIONS: The clinical profile of CAP was similar in all three centes of the observational study.However,physicians can predict drug resistance in patients with CAP by taking accoiunt of the cumulative number of risk factors.The superiority of previous use of antibiotics as risk factor may be explain with unrational use of antibiotics by physicions in Azerbaijan republic.
CLINICAL IMPLICATIONS: Ewig S,Welte T, Torres A.Rethinking the concepts of community-acquired and health-care associated pneuminia.lancet Infect Dis 2010;10:279-287. Ishida T, Hashimito T,Arita M, Ito I,Osawa M.Etiology of community- acguired pneumonia in hospitalized patients:3-year prospective study in japan.Chest 1998;114:1588-1593.
DISCLOSURE: The following authors have nothing to disclose: Alizaman Sadigov, Gulzar Aliyeva, Aynur Agayeva
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