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Nosocomial pneumococcal pneumonia in the elderly
Journal of the American Geriatrics Society
|July 1, 1981
Summary
Nosocomial pneumonia in elderly patients can be caused by Streptococcus pneumoniae. This study highlights risk factors like malignancy and COPD, and co-infections with Gram-negative bacteria.
Area of Science:
- Infectious Diseases
- Geriatrics
- Pulmonary Medicine
Background:
- Nosocomial pneumonia is a significant concern in elderly patients.
- Streptococcus pneumoniae is an underrecognized cause of hospital-acquired pneumonia in this demographic.
- Predisposing factors and co-infections complicate management.
Purpose of the Study:
- To describe the clinical and epidemiological features of nosocomial pneumococcal pneumonia in elderly patients.
- To identify common predisposing conditions and co-infections in these cases.
Main Methods:
- Retrospective review of elderly patients with nosocomial pneumonia.
- Documentation of Streptococcus pneumoniae via transtracheal aspirate (TTA) or bacteremia.
- Analysis of clinical data, predisposing illnesses, and prior antibiotic use.
Main Results:
- Seven out of 35 (20%) elderly patients with TTA-documented nosocomial pneumonia had Streptococcus pneumoniae.
- Two additional patients had bacteremia-documented nosocomial pneumococcal pneumonia.
- Malignancy and chronic obstructive pulmonary disease (COPD) were the most frequent predisposing conditions.
- Four patients had prior antibiotic therapy.
- Gram-negative aerobic pneumonia occurred before, concurrently with, or after pneumococcal pneumonia in these patients.
Conclusions:
- Streptococcus pneumoniae is an important pathogen in elderly patients with nosocomial pneumonia.
- Identifying and managing co-infections, particularly with Gram-negative bacteria, is crucial.
- Underlying conditions like malignancy and COPD increase risk.