May 1986

Bacteriology of Hospital-Acquired Pneumonia

Author Affiliations

From the Department of Medicine, Sepulveda Veterans Administration Medical Center, and the UCLA School of Medicine, Los Angeles. Dr Bartlett is presently with the Johns Hopkins Hospital, Baltimore.

Arch Intern Med. 1986;146(5):868-871. doi:10.1001/archinte.1986.00360170064009

Hospital-acquired pneumonia was studied prospectively for 3½ years in a 549-bed facility with acute medical-surgical care wards, convalescent wards, and a chronic care unit. Bacteriological studies were limited to transtracheal aspirates, pleural fluid, and blood cultures. The predominant isolates in 159 patients were gram-negative bacilli (47%), anaerobic bacteria (35%), Staphylococcus aureus (31%), and Streptococcus pneumoniae (26%). Nearly half of all specimens yielded a polymicrobial flora with more than one potential pathogen. Distribution of pathogens was similar with analysis of all patients, including patients with a monomicrobial infection and patients with bacteremic pneumonia. The prevalence of cases and distribution of bacteria were similar for patients located on acute medical-surgical wards and those in the nursing home care unit. Nosocomial pneumonia was judged directly responsible for lethal outcome in 19% of patients and a contributing factor to death in another 13%.

(Arch Intern Med 1986;146:868-871)