Adult bacteremic pneumonia: bacteriology and prognostic factors

Bacteremic pneumonia is a highly specified subgroup of pneumonia that is potentially life-threatening. In order to find out the prognostic factors in this subgroup of pneumonia, we conducted a 40-month retrospective analysis of 70 cases in our hospital. The male to female ratio was 54:16. Forty-one cases were community-acquired bacteremic pneumonia (CABP), and 29 cases were nosocomial bacteremic pneumonia (NBP). Both CABP and NBP were predominated by gram-negative bacteria. Klebsiella pneumoniae was the most common microorganism isolated in both CABP and NBP. The overall mortality was 62.9% (44/70). There was no significant difference in the mortality between CABP (61.0%) and NBP (65.5%). After univariate analysis of all possible prognostic factors, 10 variables were found to have significantly poor prognostic values. They were: 1) the presence of septic shock; 2) the use of ventilatory support; 3) the presence of radiologic spread; 4) treatment in an intensive care unit; 5) male gender; 6) the development of adult respiratory distress syndrome; 7) Klebsiella bacteremic pneumonia in patients with an alcohol habit; 8) patients with ultimately fatal underlying diseases; 9) an initial AaDO2 > 200 mmHg; and 10) an initial arterial pH < 7.25.