Postmortem bacteriology and pneumonia in a mentally retarded population.
Postmortem pathologic and bacteriologic reports were analyzed for 237 deaths occurring at a large institution for the mentally retarded from 1958 to 1973. Bronchopneumonia, aspiration pneumonia, and lipid pneumonia were frequently reported at autopsy, and in a total of 146 cases (61.6%) at least one type of pneumonia was reported. Postmortem bacteriologic cultures in a smaller group revealed high recovery rates of staphylococci (coagulase-positive), hemolytic streptococci, and gram-negative bacilli in throat and lung cultures. Enteric aerobic gram-negative bacilli were particularly frequent along with yeast (Candida albicans). The institutionalized retarded appear similar to other hospitalized populations, in that a large proportion of hospital-acquired respiratory infections is related to aerobic gram-negative bacilli. The high frequency of aspiration and its sequelae in this population is unusual, however, and post-mortem bacteriologic findings appear consistent with those of antemortem studies of cases of aspiration pneumonia.
D000293:Adolescent; D000328:Adult; D001344:Autopsy; D001996:Bronchopneumonia / Q000453:epidemiology*; D002176:Candida albicans / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008607:Intellectual Disability; D008168:Lung / Q000382:microbiology; D008297:Male; D009864:Ontario; D010614:Pharynx / Q000382:microbiology; D011014:Pneumonia / Q000453:epidemiology* / Q000382:microbiology; D011015:Pneumonia, Aspiration / Q000453:epidemiology*; D011017:Pneumonia, Lipid / Q000453:epidemiology; D012189:Retrospective Studies; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification