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Drowning associated pneumonia: a descriptive cohort

J M Tadié1, N Heming, E Serve

  • 1Université Paris Descartes, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Réanimation Médicale, France. jean-marc.tadie@egp.aphp.fr

Resuscitation
|September 13, 2011
PubMed
Abstract

Insights

Pneumonia following drowning can involve multi-drug resistant bacteria. Antibiotic treatment for drowning-associated pneumonia should target microorganisms found in the immersion water.

Area of Science:

  • Infectious Diseases
  • Environmental Microbiology
  • Critical Care Medicine

Background:

  • Pneumonia is a frequent complication of drowning.
  • Effective antibiotic therapy is crucial for life-threatening pneumonia.
  • Limited data exists on risk factors, causes, and treatment of drowning-associated pneumonia.

Purpose of the Study:

  • To identify microorganisms causing pneumonia after drowning and out-of-hospital cardiac arrest.
  • To analyze water samples from the river Seine for microbiological comparison.
  • To inform appropriate antibiotic selection for drowning-associated pneumonia.

Main Methods:

  • Retrospective study of patients with drowning-related out-of-hospital cardiac arrest (2002-2010).
  • Analysis of bacteriological lung samples (tracheal aspirate/bronchoalveolar lavage) upon admission.
  • Comparison of lung sample microbiology with samples from the river Seine.

Main Results:

  • Thirty-seven patients were included; lung samples were obtained from 21.
  • Nineteen of 21 lung samples were positive for bacteria.
  • A high prevalence of multi-drug resistant bacteria was observed in lung samples.
  • Microorganisms in river Seine samples matched those found in pneumonia cases.

Conclusions:

  • Drowning-associated pneumonia can be caused by multi-drug resistant bacteria.
  • Antibiotics for drowning pneumonia should cover bacteria prevalent in the immersion environment.
  • Water microbiology is a critical factor in treating drowning-associated pneumonia.

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