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Bacteriology of Hospital-Acquired Pneumonia

John G. Bartlett, MD; Paul O'Keefe, MD; Francis P. Tally; Thomas J. Louie; Sherwood L. Gorbach
Arch Intern Med. 1986;146(5):868-871. doi:10.1001/archinte.1986.00360170064009.
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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)


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