INCIDENCE OF HOSPITAL-ACQUIRED PNEUMONIA IN PATIENTS WITH COMORBIDITY AND WITH NO PREVIOUS COMORBIDITY IN THE TERTIARY CARE HOSPITAL

Abstract

Background:Hospital-acquired pneumonia (HAP) is a leading nosocomial infection associated with significant morbidity, mortality, and healthcare burden, particularly in high-risk patients. Despite its global impact, epidemiological data from South Asia remain limited and heterogeneous. This study aimed to evaluate the incidence, risk factors, microbiological spectrum, and clinical outcomes of HAP in patients with and without comorbidities at a tertiary care hospital in Pakistan.

Materials and Methods:This cross-sectional study was conducted at Federal Government Polyclinic Hospital, Islamabad, from November 2024 to April 2025, and included 250 adult inpatients hospitalized for more than 48 hours. Hospital-acquired pneumonia (HAP) was diagnosed using CDC criteria, while comorbidities and smoking history were systematically documented. Microbiological cultures, antimicrobial susceptibility, and clinical outcomes including ICU admission, ventilatory support, mortality, and length of stay were recorded. All data was entered and calculated using SPSS version 23.0. The statistical significance set at p ≤ 0.05.

Results:Among 250 hospitalized patients, hospital-acquired pneumonia occurred in 20.0% of patients and was significantly associated with chronic kidney disease, immunosuppression, malignancy, diabetes, hypertension, chronic lung disease, smoking, and age ≥60 years. Gram-negative bacilli, predominantly Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, showed high multidrug resistance. Clinical outcomes were severe, with 56.0% requiring ICU care and 24.0% mortality.

Conclusion:Hospital-acquired pneumonia affected one-fifth of patients, with older age, comorbidities, and smoking identified as key risk factors. Multidrug-resistant gram-negative bacilli predominated, and HAP was associated with prolonged hospitalization, increased ICU admissions, and high mortality, highlighting the importance of timely prevention and rational antibiotic stewardship.