The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-100 : Critical Care ; Prevalence of Multi-Drug Resistant Organism Colonization with Pulmonary Tuberculosis in Critically Ill Patients = The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-100 : Critical Care ; Prevalence of Multi-Drug Resistant Organism Colonization with Pulmonary Tuberculosis in Critically Ill Patients

다국어 초록 (Multilingual Abstract)

Background: Pulmonary tuberculosis (TB) is different from bacterial pneumonia in terms of patient demographic characteristics, use of antimicrobial agents, and treatment environment such as air-borne precaution and isolation. We hypothesized that the prevalence of multi-drug resistant organisms (MDRO) might be different in patientswith TB from that of community acquired pneumonia (CAP) among critically ill patients. Methods: All TB or CAP patients admitted to the intensive care unit (ICU) of the hospital in Korea from January 2009 to July 2014 were included. Patients were excluded from the study if there was a prior history of MDRO, hospitalization for =2 days in the preceding 90 days, or antimicrobial therapy in the preceding 30 days. The patients admitted ICU due to other than respiratory failure were also excluded. Results: 26 TB patients and 43 CAP patients were included in the study. Compared with CAP group, the TB group was younger and had less comorbidities. Duration of delay to ICU admission and/or initiation of effective medication were longer in patients with TB. The prevalence of MDRO colonization was not different in both groups (26.9% in TB group and 27.9% in CAP group) and multi-drug resistant Acinetobacter baumanii was the most frequently isolated MDRO (21.7%). The rate of ventilator associated pneumonia (VAP) in TB group (23.1%) was also similar to that of CAP group (16.3%). The proportion of ARDS and multi-organ failure were higher in patients with TB. 18 (69.2%) and 15 (34.9%) patients were dead in TB and CAP group, respectively. Conclusions: The prognosis of patients with TB requiring intensive care was worse than the patients with severe CAP in ICU. However, the prevalence of MDRO colonization and rate of VAP were not different in both group of patients.