[Comparative study of nosocomial and community acquired lower respiratory tract infections. A prospective study of 232 cases].
Quantitative sputum culture, single catheter protected specimen brush, blood culture, culture of pleural and other body fluid were used in a prospective study of 232 cases of lower respiratory tract infection. 123 cases of nosocomial infection (Group 1) and 109 cases of community acquired infection (Group 2) were analyzed comparatively. Significant underlying diseases were present in 100% of Group 1 and 66.1% of Group 2. 74.8% of Group 1 and 9.2% of Group 2 had previous antimicrobial therapy with two antibiotics or more. 123 species of bacteria were isolated in 82 cases (66.7%) in group 1. The predominant pathogens were Gram-negative bacilli (60.6%), such as Enteric coli and Pseudomonas aeruginosa etc. In group 2, 89 species were obtained in 83 cases (76.2%). Gram-positive Streptococcus was 48.6% (Streptococcus pneumoniae 15.6%). Polymicrobial infections, fungal infections and bilateral involvement on radiography were more common in Group 1 than in group 2. Mortality was 8.1% in Group 1 and 0 in Group 2 (P less than 0.01). It is suggested that patients who had underlying diseases and inappropriate antibiotic therapy were at increased risk for nosocomial infections.
Huang
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Department of Respiration, Chang Hai Hospital, Second Military Medical University, Shanghai.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology / Q000382:microbiology; D011446:Prospective Studies; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000209:etiology* / Q000382:microbiology; D013290:Streptococcal Infections; D013296:Streptococcus pneumoniae / Q000302:isolation & purification