[Clinical analysis of pneumonia in the elderly in a community hospital--comparison of community-acquired pneumonia and nosocomial pneumonia].
We experienced 530 elderly cases with pneumonia among 930 patients with pneumonia in Kawasaki Medical School Kawasaki Hospital between April 1986 and September 1998. Clinical analysis of all these patients and a comparison of one group consisting of 418 patients with community-acquired pneumonia and another group composed of 112 patients with nosocomial pneumonia were performed. In all of the elderly patients with pneumonia, respiratory symptoms and inflammatory findings were less frequent, but were frequent for those in poor general and nutritional condition. The causative microorganism was isolated in 42% of these patients. Streptococcus pneumoniae, MSSA and Klebsiella pneumoniae were frequently isolated from the sputum of the patients with community-acquired pneumonia, while Methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Methicillin-sensitive Staphylococcus aureus (MSSA) were frequently isolated from that of nosocomial pneumonia patients. Mycoplasma pneumoniae, Chlamydia pneumoniae and some viruses were less frequent for patients in both groups. Although many intravenous antibiotics, such as cephem or carbapenem were administered to patients in both groups, the prognosis was relatively good for those with community acquired pneumonia but was extremely poor for those with nosocomial pneumonia despite mechanical ventilation or steroid pulse therapy for many patients.
Kobashi
Y
Y
Department of Medicine, Kawasaki Medical School, Kawasaki Hospital.
Fujita
K
K
Karino
T
T
Yano
T
T
Nakamura
J
J
Okimoto
N
N
Matsushima
T
T
Soejima
R
R
D000368:Aged; D017714:Community-Acquired Infections / Q000382:microbiology* / Q000628:therapy*; D003428:Cross Infection / Q000382:microbiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000382:microbiology* / Q000628:therapy*