Nosocomial Hemophilus pneumonia in patients with severe trauma

In recent years, there have been increasing reports of Hemophilus pneumonia in adults. With few exceptions, these reports described Hemophilus as a cause of community acquired pneumonia. In the past three years, however, we have seen 15 instances of nosocomial Hemophilus pneumonia in patients with trauma who are intubated. This represented 11 per cent of the incidences of pneumonia that we diagnosed in this time period. The average age of the patient was 36 years and most patients had been in motor vehicle accidents. Six had received antibiotics and nine, steroids prior to their infection. Of note is that all incidences of Hemophilus pneumonia occurred within 11 days of hospitalization. This suggested to us that although the infections were clearly nosocomial, the organisms were probably not hospital acquired. Nevertheless, Hemophilus should be considered a potential cause of early pneumonia in the patients with trauma who are intubated.