Risk factors for antibiotic-resistant respiratory infections among patients requiring ward admission

Kerem Ensarioğlu; Berna Akıncı Özyürek; Tuğçe Şahin Özdemirel; Esma Sevil Akkurt; Özlem Özdağ; Hasan İbiş; Almila Sena Akın Şencan

Makale detayları

Risk factors for antibiotic-resistant respiratory infections among patients requiring ward admission

Yazarlar:

Kerem Ensarioğlu | Berna Akıncı Özyürek | Tuğçe Şahin Özdemirel | Esma Sevil Akkurt | Özlem Özdağ | Hasan İbiş | Almila Sena Akın Şencan

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Göğüs Hastalıkları

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.98-104

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343393

pISSN:

2717-7505

Anahtar kelimeler:

Özet:

 Aims: The airway flora has been recognized as non-sterile, and sputum sampling is recommended for hospitalized patients with respiratory infections. Empiric antibiotic treatment is often initiated without culture confirmation, potentially contributing to antimicrobial resistance. This study aims to assess the influence of demographic factors, prior antibiotic use, and other risk factors on resistant respiratory cultures in ward-admitted patients. Methods: A single-center cohort study was conducted in a pulmonary medicine ward of a tertiary hospital between the dates of March 2024 and September 2024. Patients over 18 years old with sputum, bronchoalveolar lavage BAL, or endotracheal aspiration culture results were included. Demographic characteristics, comorbidities, vaccination status, prior infections, respiratory support needs, antibiotic history, and hospital admission records were collected. Nonparametric statistical analyses were used to evaluate associations, including the Mann-Whitney U and Kruskal-Wallis tests. Results: Among 70 patients mean age 68 9 years, 87 male, chronic obstructive pulmonary disease COPD 71.4 was the most prevalent comorbidity. A total of 75.7 of cultures were from sputum samples, with Pseudomonas spp. 27.1, Klebsiella pneumoniae 20 and Escherichia coli 14.3 being the most frequently isolated organisms. Resistant cultures were more common in patients with intensive care unit ICU admission history p0.007, intubation history p0.003, and non-invasive mechanical ventilation NIMV use p0.038. No correlation was found between prior antibiotic use and resistance. Conclusion: ICU admission and respiratory support requirements were key risk factors for resistance. Contrary to previous studies, prior antibiotic use and comorbidities did not significantly impact resistance rates. These findings highlight the need for targeted antimicrobial stewardship and careful risk assessment among patients requiring pulmonary ward admission.

 Aims: The airway flora has been recognized as non-sterile, and sputum sampling is recommended for hospitalized patients with respiratory infections. Empiric antibiotic treatment is often initiated without culture confirmation, potentially contributing to antimicrobial resistance. This study aims to assess the influence of demographic factors, prior antibiotic use, and other risk factors on resistant respiratory cultures in ward-admitted patients. Methods: A single-center cohort study was conducted in a pulmonary medicine ward of a tertiary hospital between the dates of March 2024 and September 2024. Patients over 18 years old with sputum, bronchoalveolar lavage BAL, or endotracheal aspiration culture results were included. Demographic characteristics, comorbidities, vaccination status, prior infections, respiratory support needs, antibiotic history, and hospital admission records were collected. Nonparametric statistical analyses were used to evaluate associations, including the Mann-Whitney U and Kruskal-Wallis tests. Results: Among 70 patients mean age 68 9 years, 87 male, chronic obstructive pulmonary disease COPD 71.4 was the most prevalent comorbidity. A total of 75.7 of cultures were from sputum samples, with Pseudomonas spp. 27.1, Klebsiella pneumoniae 20 and Escherichia coli 14.3 being the most frequently isolated organisms. Resistant cultures were more common in patients with intensive care unit ICU admission history p0.007, intubation history p0.003, and non-invasive mechanical ventilation NIMV use p0.038. No correlation was found between prior antibiotic use and resistance. Conclusion: ICU admission and respiratory support requirements were key risk factors for resistance. Contrary to previous studies, prior antibiotic use and comorbidities did not significantly impact resistance rates. These findings highlight the need for targeted antimicrobial stewardship and careful risk assessment among patients requiring pulmonary ward admission.

 Aims: The airway flora has been recognized as non-sterile, and sputum sampling is recommended for hospitalized patients with respiratory infections. Empiric antibiotic treatment is often initiated without culture confirmation, potentially contributing to antimicrobial resistance. This study aims to assess the influence of demographic factors, prior antibiotic use, and other risk factors on resistant respiratory cultures in ward-admitted patients. Methods: A single-center cohort study was conducted in a pulmonary medicine ward of a tertiary hospital between the dates of March 2024 and September 2024. Patients over 18 years old with sputum, bronchoalveolar lavage BAL, or endotracheal aspiration culture results were included. Demographic characteristics, comorbidities, vaccination status, prior infections, respiratory support needs, antibiotic history, and hospital admission records were collected. Nonparametric statistical analyses were used to evaluate associations, including the Mann-Whitney U and Kruskal-Wallis tests. Results: Among 70 patients mean age 68 9 years, 87 male, chronic obstructive pulmonary disease COPD 71.4 was the most prevalent comorbidity. A total of 75.7 of cultures were from sputum samples, with Pseudomonas spp. 27.1, Klebsiella pneumoniae 20 and Escherichia coli 14.3 being the most frequently isolated organisms. Resistant cultures were more common in patients with intensive care unit ICU admission history p0.007, intubation history p0.003, and non-invasive mechanical ventilation NIMV use p0.038. No correlation was found between prior antibiotic use and resistance. Conclusion: ICU admission and respiratory support requirements were key risk factors for resistance. Contrary to previous studies, prior antibiotic use and comorbidities did not significantly impact resistance rates. These findings highlight the need for targeted antimicrobial stewardship and careful risk assessment among patients requiring pulmonary ward admission.

 Amaç: Hava yolu florasının steril olmadığı kabul edilmekte olup, solunum yolu enfeksiyonu nedeniyle hastaneye yatırılan hastalarda balgam örneklemesi önerilmektedir. Kültür doğrulaması yapılmadan ampirik antibiyotik tedavisine başlanması, antimikrobiyal dirence katkıda bulunabilir. Bu çalışmanın amacı, hastane servisinde takip edilen hastalarda demografik faktörler, önceki antibiyotik kullanımı ve diğer risk faktörlerinin dirençli solunum yolu kültürleri üzerindeki etkisini değerlendirmektir. Yöntemler: Bu tek merkezli kohort çalışması, üçüncü basamak bir hastanenin göğüs hastalıkları servisinde yürütülmüştür. Çalışmaya, balgam, bronkoalveoler lavaj BAL veya endotrakeal aspirasyon kültür sonuçları bulunan 18 yaş üzeri hastalar dahil edilmiştir. Demografik özellikler, ek hastalıklar, maruziyet öyküsü, aşı durumu, önceki enfeksiyonlar, solunum desteği gereksinimi, antibiyotik kullanım öyküsü ve hastane yatış hikayesi kayıt altında alınmıştır. Korelasyonların değerlendirilmesinde Mann-Whitney U ve Kruskal-Wallis testleri kullanılmıştır. Bulgular: Çalışmaya dahil edilen 70 hastanın yaş ortalaması 68  9 yıl olup, 87si erkekti. En yaygın komorbidite KOAH 71,4 idi. Kültürlerin 75,7si balgam örneklerinden elde edilmiş olup, en sık izole edilen mikroorganizmalar Pseudomonas spp. 27,1, Klebsiella pneumoniae 20 ve Escherichia coli 14,3 idi. Dirençli kültürlerin, yoğun bakım yatış öyküsü olan p0.007, entübasyon öyküsü bulunan p0.003 ve non-invaziv mekanik ventilasyon NIMV kullanımı olan hastalarda p0.038 daha yaygın olduğu saptandı. Önceki antibiyotik kullanımı ile direnç arasında anlamlı bir ilişki bulunamadı. Tartışma: Yoğun bakım yatışı ve solunum desteği gereksinimi, direnç gelişimi açısından önemli risk faktörleri olarak belirlendi. Önceki çalışmalardan farklı olarak, daha önce antibiyotik kullanımı ve komorbiditelerin direnç oranları üzerinde belirgin bir etkisi olmadığı görüldü. Bu bulgular, akılcı antibiyoterapi yönetim stratejilerinin ve risk değerlendirmelerinin, göğüs hastalıkları servisine yatışı gereken hastalar arasında önemli olduğunu vurgulamaktadır.

Makale detayları

Risk factors for antibiotic-resistant respiratory infections among patients requiring ward admission

Yazarlar:

Kerem Ensarioğlu | Berna Akıncı Özyürek | Tuğçe Şahin Özdemirel | Esma Sevil Akkurt | Özlem Özdağ | Hasan İbiş | Almila Sena Akın Şencan

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Göğüs Hastalıkları

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.98-104

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343393

pISSN:

2717-7505

Antimicrobial resistance

hospitalization

respiratory tract infections

risk factorsAntimikrobiyal Direnç

Hastaneye Yatış

Solunum Yolu Enfeksiyonları

Risk Faktörleri

Sayı

Makale detayları

Yazarlar: Kerem Ensarioğlu | Berna Akıncı Özyürek | Tuğçe Şahin Özdemirel | Esma Sevil Akkurt | Özlem Özdağ | Hasan İbiş | Almila Sena Akın Şencan

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Göğüs Hastalıkları

Dergi: Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.98-104

Belge Tipi: Makale

Yayın Tarihi: 3/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001343393

pISSN: 2717-7505

Sayı

Yazarlar:

Kerem Ensarioğlu | Berna Akıncı Özyürek | Tuğçe Şahin Özdemirel | Esma Sevil Akkurt | Özlem Özdağ | Hasan İbiş | Almila Sena Akın Şencan

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Göğüs Hastalıkları

Dergi:

Journal of Medicine and Palliative Care Vol.6 Issue 2, pp.98-104

Belge Tipi:

Makale

Yayın Tarihi:

3/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001343393

pISSN:

2717-7505