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Pneumonia in a nursing home

P J Drinka1, C Gauerke, S Voeks

  • 1Wisconsin Veterans Home, King 54946-0620.

Journal of General Internal Medicine
|November 1, 1994
PubMed

Insights

This study investigated atypical pneumonia causes in nursing home residents. Serological tests did not confirm atypical organisms, highlighting the need for broad-spectrum antibiotics covering common bacteria.

Area of Science:

  • Infectious Diseases
  • Geriatric Medicine
  • Microbiology

Background:

  • Radiologic pneumonia is common in nursing home residents.
  • Atypical organisms are potential, yet often unconfirmed, causes of pneumonia in this population.

Purpose of the Study:

  • To determine if atypical organisms (Legionella, Mycoplasma, Chlamydia) cause radiologic pneumonia in nursing home residents.
  • To evaluate the efficacy of serological testing for diagnosing atypical pneumonia in this demographic.

Main Methods:

  • Serological examinations for Legionella, Mycoplasma, and Chlamydia were performed on nursing home residents with pneumonia.
  • Sputum cultures were analyzed, and mortality rates were reviewed over a one-year period.
  • Fifty-six pneumonia episodes in residents with a mean age of 78 years were studied.

Main Results:

  • No significant fourfold titer changes were observed, failing to serologically confirm atypical pneumonia.
  • Sputum cultures identified common bacteria such as Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus.
  • The two-month mortality rate among the studied residents was 21%.

Conclusions:

  • Serological testing did not confirm atypical organisms as a cause of radiologic pneumonia in this nursing home cohort.
  • Antibiotic selection for pneumonia in nursing home residents should prioritize coverage for prevalent pathogens like Hemophilus influenzae, Moraxella, and Staphylococcus.
  • Clinical presentation remains a crucial factor in guiding antibiotic therapy decisions.

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