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[Studies of polymicrobial infection on pneumonia by transtracheal aspiration in the elderly]
K Yamamoto1, Y Yamada, Y Hayashi
1First Department of Internal Medicine, Nagoya City University, Medical School.
Abstract:
We studied the polymicrobial infection by transtracheal aspiration (TTA) on pneumonia in the elderly. Incidence of mixed isolation of organisms from TTA was 35% or 39 out of 111 episodes. The principal organisms in polymicrobial infection detected from TTA were S. aureus (N.23), P. aeruginosa (N. 15), K. pneumoniae (N. 12) and S. pneumoniae (N. 11). The principal combination of mixed infection were S. aureus + P. aeruginosa (N.7), S. aureus + K. pneumoniae (N.5), S. aureus + S. marcescens (N.5), S. aureus + S. pneumoniae (N.5), S. aureus + Anaerobes (N.4) and K. pneumoniae + P. aeruginosa (N.4). Hospital acquired pneumonia was of a higher rate of mixed infection than the nursing home acquired pneumonia. In the mixed infection on pneumonia in the elderly, normal upper airway flora was highly detected with pathogens from transtracheal aspirates. From these results, we realize that aspiration and superinfection were important factors in mixed infection in the elderly.
Insights
Polymicrobial pneumonia in the elderly often involves multiple bacteria, with Staphylococcus aureus and Pseudomonas aeruginosa being common. Aspiration and superinfection are key factors in these elderly patients with pneumonia.
Area of Science:
- Infectious Diseases
- Geriatrics
- Microbiology
Background:
- Pneumonia in the elderly is a significant health concern.
- Polymicrobial infections are increasingly recognized in this demographic.
Purpose of the Study:
- To investigate the incidence and characteristics of polymicrobial pneumonia in elderly patients.
- To identify the primary pathogens and common combinations involved in mixed infections.
Main Methods:
- Transtracheal aspiration (TTA) was used to collect samples from elderly patients with pneumonia.
- Microbiological analysis was performed to identify isolated organisms.
Main Results:
- The incidence of polymicrobial infection detected by TTA was 35% (39/111 episodes).
- Key pathogens included S. aureus, P. aeruginosa, K. pneumoniae, and S. pneumoniae.
- Common combinations involved S. aureus with P. aeruginosa, K. pneumoniae, S. marcescens, S. pneumoniae, or anaerobes.
- Hospital-acquired pneumonia showed a higher rate of mixed infection compared to nursing home-acquired pneumonia.
- Normal upper airway flora was frequently detected alongside pathogens in TTA samples.
Conclusions:
- Aspiration and superinfection are critical factors contributing to polymicrobial pneumonia in the elderly.
- Understanding these factors is crucial for effective diagnosis and treatment strategies.