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Bacteriology and treatment of gram-negative pneumonia in long-term hospitalized children
Insights
This study found that gentamicin effectively treated Gram-negative bacillary pneumonia in hospitalized children. All 39 children recovered, highlighting its efficacy in pediatric cases.
Area of Science:
- Pediatric Infectious Diseases
- Pulmonology
- Microbiology
Background:
- Gram-negative bacillary pneumonia is a serious infection in hospitalized children.
- It can manifest as pneumonitis, necrotizing pneumonia, or lung abscess, sometimes with empyema.
Purpose of the Study:
- To evaluate the efficacy of gentamicin in treating Gram-negative bacillary pneumonia in pediatric patients.
- To identify common Gram-negative bacterial pathogens responsible for pneumonia in this population.
Main Methods:
- 39 long-term hospitalized children diagnosed with Gram-negative bacillary pneumonia were studied.
- Percutaneous transtracheal aspiration was used for specimen culture.
- Patients were treated with gentamicin for 10-26 days, with additional agents for resistant organisms.
Main Results:
- Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were the most frequent isolates.
- An average of 3.5 isolates were recovered per specimen.
- All 39 patients achieved a cure with gentamicin treatment.
Conclusions:
- Gentamicin is a highly effective antibiotic for treating Gram-negative bacillary pneumonia in hospitalized children.
- Prompt diagnosis and appropriate antibiotic therapy are crucial for favorable outcomes.
Abstract:
Gram-negative bacillary pneumonia was diagnosed in 39 longterm hospitalized children, ranging in age from 4 months to 14 years (mean seven years). Fifteen had pneumonitis, 18 necrotizing pneumonia, and six lung abscess. An associated empyema was noted in six cases. Specimens for culture were obtained through percutaneous transtracheal aspiration. Five microorganisms were the predominant isolates: P aeruginosa (13 instances), K pneumoniae (11), E coli (7), S marcescens (6), and P mirabilis (2). There were 112 aerobic and 25 anaerobic isolates recovered from the 39 patients, accounting for 3.5 isolates per specimen. Other aerobic and or anaerobic organisms were mixed with the Gram-negative bacilli in half the patients. All patients were treated with gentamicin for 10 to 26 days (average 19.5 days), and all were cured. In 12 patients in whom other organisms resistant to gentamicin were also present, other antimicrobial agents were concomitantly administered.