Respiratory tract colonization and incidence of secondary infection during hospital treatment of community-acquired pneumonia.
In a prospective study of 245 patients with community-acquired pneumonia, the respiratory tract of 93 patients (38%) became colonized during hospitalization. Gram-negative rods and Candida spp. predominated, and in more than 75% of cases colonization occurred within 72 h after admission. Multivariate analysis showed that colonization was significantly associated with increasing age, presence of chronic disease, and with decreasing serum albumin and a respiratory rate of greater than 30/min on admission. Colonization was a negative prognostic factor, associated with a 14-fold higher mortality (10% vs. 0.7%), doubled length of hospital stay and a slower recovery. Seventeen patients developed a secondary infection. However, only two had lower respiratory tract infection, and one (0.4%) pneumonia verified by X-ray. The previously reported high risk of respiratory superinfection in this category of patient does not seem to apply today.
Ortqvist
A
A
Department of Infectious Diseases, Karolinska Institute, Danderyd, Sweden.
Hammers-Berggren
S
S
Kalin
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000254:growth & development*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000254:growth & development*; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*