NOSOCOMIAL GRAM-NEGATIVE BACILLARY PNEUMONIA IN ELDERLY PATIENTS / 解放军医学杂志

ABSTRACT

Two hundred thirty-nine cases of hospital-acquired gram-negative bacillary pneumonia in elderly patients were reported.The diagnostic criteria of these cases were(l)discharged from Jan.1,1982 to Dec.31,1988;(2)aged 60 or more;(3)onset of clinical manifestations of pneumonia was ≥72h after admission;(4)without preceding pulmonary infections before admission;(5)increased production of purulent sputum and/or fever,chest pain,productive cough,etc.;(6)infiltrate on chest roentgenologic examination or characteristic moist rales consistent in the absence of x-ray findings;(7)sputum culture positive for gramnegative bacilli.The morbidity rate was 2.56% (239/9318).The main underlying diseases of these cases were malignancies,blood dyscrasia,cerebrovascular accident and chronic obstructive pulmonary diseases.There were 88 cases (36.8%) received tracheotomy and/or artificial ventilation.The predominent pathogenic bacteria were Ps.aeruginosa E.coli and K.pneumoniae.Environmental bacterial flora surveillance showed about 75% of the staff members as well as patients' fingers,nostrils and sleeves carried Ps.aeruginosa,B.anitratum,S.aureus or epidtfrmitis.The prompt use of,antibiotics is important.A?-lactam antibiotic combined with an aminoglycoside is preferential.