title: [Clinical analysis of nursing home-acquired pneumonia in a community hospital].
abstract: To clarify the characteristic features of nursing home-acquired pneumonia in our community hospital, we performed a clinical analysis of 86 patients with nursing home-acquired pneumonia. The patients were divided into young and elderly groups. In the young group cerebral palsy was the underlying disease. In the elderly group, it was cerebrovascular attack. Although there were no differences in ADL, the nutritional condition of the young group was comparatively good, the isolated microorganism consisted of mostly Mycoplasma pneumoniae and the prognosis was good. The elderly group where the nutritional condition was poor, the patients were detected by non-respiratory symptoms and risk factors such as obvious episodes of aspiration led us to be concerned about the risk factors for nursing home-acquired pneumonia. The microorganism isolated from the sputum of the elderly group was frequently a multi-drug resistant microorganism such as Methicillin-resistant Staphylococcus aureus (MRSA) and polymicrobial infection. Their prognosis was poor despite treatment with multiple antibiotics. In the comparative study between survivors and non-survivors in the elderly group, risk factors such as hypotension, consciousness disturbance, the extension of infiltration shadows, respiratory failure, multiple organ failure and metabolic acidosis were influenced for the prognosis, but the isolated microorganisms and the antimicrobial agents were not concerned.
authors.affiliation: Department of Medicine, Kawasaki Medical School, Kawasaki Hospital, Okayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kobashi
authors.forename: H
authors.initials: H
authors.lastname: Ohba
authors.forename: H
authors.initials: H
authors.lastname: Yoneyama
authors.forename: N
authors.initials: N
authors.lastname: Okimoto
authors.forename: T
authors.initials: T
authors.lastname: Matsushima
authors.forename: R
authors.initials: R
authors.lastname: Soejima
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003428:Cross Infection; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D018410:Pneumonia, Bacterial / Q000635:transmission*