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July 1974

Pneumonia in an Intensive Care UnitA 30-Month Experience

Author Affiliations

Baltimore; Springfield, Mass; Boston

From the Department of Medicine, Johns Hopkins Hospital, Baltimore (Dr. Stevens); Springfield Hospital Medical Center, Springfield, Mass (Dr. Teres); and the Harvard Medical School and Beth Israel Hospital, Boston (Drs. Skillman and Feingold).

Arch Intern Med. 1974;134(1):106-111. doi:10.1001/archinte.1974.00320190108015

Cases of pneumonia during the first 21/2 years of a respiratory-surgical intensive care unit (R-SICU) were analyzed. One hundred fifty-eight episodes of pneumonia were identified in 153 patients. Patients without pneumonia had a mortality of 3.8%. Patients admitted with or acquiring Gram-positive pneumonia did not have increased mortality. Patients who had Gram-negative pneumonias without involvement by Pseudomonas aeruginosa had a mortality of 33%. Isolation of Pseudomonas from respiratory cultures obtained from patients with pneumonia was associated with a mortality of 70%. Overall mortality of all patients admitted during the 30-month period was 13%. Eastablished Gram-negative Bacillus pneumonias are common, dangerous, and often not effectively treated. Environmental sources of Gram-negative pathogens should be reduced. Prophylactic regimens to prevent colonization of the respiratory tract may be helpful.