Epidemiology and Risk Factors of Hospital-Acquired Pneumonia in Chinese Adults: A Multicenter Retrospective Study

Hospital-acquired pneumonia (HAP) is a major type of hospital-acquired infection with substantial morbidity. Large-scale epidemiological data on HAP in China remain limited. This multi-center retrospective study investigates the epidemiology, etiology, and risk factors of HAP to support clinical management.

From January to December 2019, 543 patients from 37 tertiary hospitals meeting the enrollment criteria (who meet the diagnosis of HAP according to the Guidelines for the Diagnosis and Treatment of HAP in Adults in China and have clear clinical outcomes) were included. Patient data were retrospectively analyzed.

The study recorded 15.8% overall mortality. Multivariate analysis identified independent risk factors including secondary ventilator-associated pneumonia, admission to the intensive care unit, positive airway secretion culture, liver dysfunction, heart failure, cancer, long-term catheter indwelling, sequential organ failure assessment (SOFA) score >2 and quick SOFA (qSOFA) score >1 (p < 0.05). The top four pathogens of HAP were Acinetobacter baumannii (24.89%), Klebsiella pneumoniae (21.57%), Pseudomonas aeruginosa (13.73%), and Staphylococcus aureus (5.88%).

Given the high mortality rate associated with HAP, prevention and early diagnostic assessment of HAP during hospitalization are paramount for these patients. The main pathogens of HAP are Gram-negative bacteria, which frequently exhibit substantial antimicrobial resistance. Therefore, antibiotics should be selected carefully.