Nosocomial pneumococcal pneumonia in the elderly

Among 35 elderly patients with transtracheal aspirate (TTA)-documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic obstructive pulmonary disease were the most common predisposing illnesses. Four of the 9 patients had previously received antibiotic therapy. Gram-negative aerobic pneumonia was found before (2 cases), concomitant with (3 cases), and after (2 cases) the pneumococcal infection in these patients.