AIMS: To determine the incidence, microbial cause, and outcome of nosocomial pneumonia in adult general medical and surgical patients at Christchurch Hospital. METHOD: A one-year prospective study of consecutive patients developing nosocomial pneumonia in a university-affiliated hospital. Expanded diagnostic laboratory testing was undertaken to identify the microbial cause of pneumonia. RESULTS: We recruited 126 patients, which represented an incidence of 6.1 per 1,000 admissions. Only 52 (41%) patients submitted sputum that satisfied the cytological screening criteria for testing. A microbial cause was identified in 47 cases (37%): the most common was Legionella spp. (sixteen cases), followed by Influenza A (six cases) and Staphylococcus aureus (four cases). We did not identify an environmental source of the Legionella species. Fourteen patients (11%) died as a consequence of pneumonia and nearly all of these had significant comorbidity. Renal impairment, alcohol excess, and severity of pneumonia were the most powerful predictors of a fatal outcome by univariate analysis. CONCLUSIONS: In most patients we did not identify a microbial cause of pneumonia; when we did, Legionella species were the most common, although this micro-organism has a long incubation period so some subjects may have acquired it before admission. These results guide preventative efforts, diagnostic testing and selection of antimicrobial therapy for nosocomial pneumonia in our hospital.
AIMS: To determine the incidence, microbial cause, and outcome of nosocomial pneumonia in adult general medical and surgical patients at Christchurch Hospital. METHOD: A one-year prospective study of consecutive patients developing nosocomial pneumonia in a university-affiliated hospital. Expanded diagnostic laboratory testing was undertaken to identify the microbial cause of pneumonia. RESULTS: We recruited 126 patients, which represented an incidence of 6.1 per 1,000 admissions. Only 52 (41%) patients submitted sputum that satisfied the cytological screening criteria for testing. A microbial cause was identified in 47 cases (37%): the most common was Legionella spp. (sixteen cases), followed by Influenza A (six cases) and Staphylococcus aureus (four cases). We did not identify an environmental source of the Legionella species. Fourteen patients (11%) died as a consequence of pneumonia and nearly all of these had significant comorbidity. Renal impairment, alcohol excess, and severity of pneumonia were the most powerful predictors of a fatal outcome by univariate analysis. CONCLUSIONS: In most patients we did not identify a microbial cause of pneumonia; when we did, Legionella species were the most common, although this micro-organism has a long incubation period so some subjects may have acquired it before admission. These results guide preventative efforts, diagnostic testing and selection of antimicrobial therapy for nosocomial pneumonia in our hospital.
Authors: Hervé Dupont; Philippe Montravers; Rémy Gauzit; Benoît Veber; Jean-Louis Pouriat; Claude Martin Journal: Intensive Care Med Date: 2003-01-14 Impact factor: 17.440
Authors: Marta Di Pasquale; Stefano Aliberti; Marco Mantero; Sonia Bianchini; Francesco Blasi Journal: Int J Mol Sci Date: 2016-02-25 Impact factor: 5.923
Authors: Jin-Young Min; Hye-Jin Kim; Chungsik Yoon; Kiyoung Lee; Myoungsouk Yeo; Kyoung-Bok Min Journal: Int J Environ Res Public Health Date: 2018-06-05 Impact factor: 3.390