F-37 : Free Paper Presentation ; Prediction of Drug Resistant Pathogens with Current Criteria of Healthcare-associated Pneumonia = F-37 : Free Paper Presentation ; Prediction of Drug Resistant Pathogens with Current Criteria of Healthcare-associated Pneumonia

다국어 초록 (Multilingual Abstract)

Healthcare-associated pneumonia includes a heterogeneous group of patients in frequent contact with health care systems. However, current criteria of HCAP poorly predict the potentially drug-resistant pathogens (PDR). The objective of this review is to assess the accuracy of prediction of PDR pathogens using HCAP criteria. Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched. We examined the titles and abstracts of 6383 articles and the full-text versions of 1598 articles. We included 21 studies in our review and calculated pooled sensitivities and specificities with 95% confidence intervals (CI).Twenty one articles included 12597 patients (7658 community acquired pneumonia and 4939 HCAP patients) from 8 different countries. Pooled sensitivity was 0.65 (95% CI 0.63-0.66) and specificity was 0.70 (95% CI 0.69-0.71). With 10 studies provided all PDR pathogens, sensitivity was 0.66 (95% CI 0.63-0.69) and specificity was 0.69 (95% CI 0.65-0.68). With only Asian population, sensitivity was 0.68 (95% CI 0.65-0.70) and specificity was 0.60 (95% CI 0.58-0.62) while non-Asian population showed sensitivity of 0.63 (95% CI 0.61-0.65) and specificity of 0.74 (95% CI 0.73-0.75). Six prospective studies showed sensitivity of 0.65 (95% CI 0.59-0.70) and specificity of 0.73 (95% CI 0.71-0.74) while 15 retrospective studies showed sensitivity of 0.65 (95% CI 0.63-0.66) and specificity of 0.68 (95% CI 0.67-0.69).Current HCAP criteria comprise a heterogenous group of pneumonia patients and its predictive strength for specific PDR pathogens remains insufficient.Healthcare-associated pneumonia includes a heterogeneous group of patients in frequent contact with health care systems. However, current criteria of HCAP poorly predict the potentially drug-resistant pathogens (PDR). The objective of this review is to assess the accuracy of prediction of PDR pathogens using HCAP criteria. Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched. We examined the titles and abstracts of 6383 articles and the full-text versions of 1598 articles. We included 21 studies in our review and calculated pooled sensitivities and specificities with 95% confidence intervals (CI).Twenty one articles included 12597 patients (7658 community acquired pneumonia and 4939 HCAP patients) from 8 different countries. Pooled sensitivity was 0.65 (95% CI 0.63-0.66) and specificity was 0.70 (95% CI 0.69-0.71). With 10 studies provided all PDR pathogens, sensitivity was 0.66 (95% CI 0.63-0.69) and specificity was 0.69 (95% CI 0.65-0.68). With only Asian population, sensitivity was 0.68 (95% CI 0.65-0.70) and specificity was 0.60 (95% CI 0.58-0.62) while non-Asian population showed sensitivity of 0.63 (95% CI 0.61-0.65) and specificity of 0.74 (95% CI 0.73-0.75). Six prospective studies showed sensitivity of 0.65 (95% CI 0.59-0.70) and specificity of 0.73 (95% CI 0.71-0.74) while 15 retrospective studies showed sensitivity of 0.65 (95% CI 0.63-0.66) and specificity of 0.68 (95% CI 0.67-0.69).Current HCAP criteria comprise a heterogenous group of pneumonia patients and its predictive strength for specific PDR pathogens remains insufficient.