title: Bacteremic nosocomial pneumonia. A 7-year experience in one institution.
abstract: OBJECTIVE
  To describe the epidemiology, microbiology, and outcome of nosocomial pneumonia with secondary bloodstream infection.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary care Canadian teaching hospital.
  
  
  METHODS
  Inpatients.
  
  
  METHODS
  All inpatient blood cultures were concurrently monitored over an 89 month period. Following chart review, patients experiencing nosocomial bloodstream infection due to pneumonia were identified. A standardized definition of pneumonia was used.
  
  
  RESULTS
  One hundred forty-nine episodes occurred in 145 patients, 0.66/1,000 hospital admissions, 8.4% of all nosocomial bloodstream infections. No change in rate occurred in the study period. Fifty-four percent of episodes developed in one of seven ICUs. Staphylococcus aureus was the most frequently identified etiologic organism (27%). The ICU and non-ICU cases did not differ in etiology. No organism became more prevalent during the study period. Twenty percent of patients died within 1 week of first positive culture; episodes associated with Pseudomonas species had a much higher mortality rate (45%) than other infections (14%) (p = 0.002). The ICU and non-ICU infections had a similar mortality rate.
  
  
  CONCLUSIONS
  Pneumonia is an important cause of nosocomial bloodstream infection, but it is not increasing in frequency or changing in etiology in our institution. The ICUs are a major contributor to this problem but have the same case short-term mortality rate and microbial etiology as non-ICU cases. Cases associated with Pseudomonas have a much higher mortality rate.
authors.affiliation: Infection Control Unit, University of Alberta Hospital, Edmonton, Canada.
authors.forename: G D
authors.initials: GD
authors.lastname: Taylor
authors.forename: M
authors.initials: M
authors.lastname: Buchanan-Chell
authors.forename: T
authors.initials: T
authors.lastname: Kirkland
authors.forename: M
authors.initials: M
authors.lastname: McKenzie
authors.forename: R
authors.initials: R
authors.lastname: Wiens
mesh_terms: D000416:Alberta / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D011023:Pneumonia, Staphylococcal / Q000453:epidemiology; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology