title: The bacteriology of pneumonia diagnosed in Western Australian emergency departments.
abstract: We used Western Australian emergency department data linked to hospital morbidity, death and microbiology data to describe the bacteriology of pneumonia according to age. The 'atypical' organisms and viruses were not assessed. A total of 6908 patients over a 3-year period were given an emergency department diagnosis of pneumonia, 76.9% were admitted and 6.3% died in hospital. Blood was cultured from 52.9% of patients with 6.4% growing potential pathogens. Streptococcus pneumoniae was the most common organism isolated and accounted for 92% of pathogens in those aged <15 years. Isolation of Enterobacteriaceae species tended to increase with age and accounted for around 25% of isolates from the elderly. Sputum was cultured from 25.3% of patients and bacteria were isolated from 30.3% of samples, commonly Haemophilus influenzae and S. pneumoniae. Isolates from sputum showed no distinct trend across age groups. These patterns question the value of routine blood and sputum cultures and have implications for empiric therapy for the elderly.
authors.affiliation: Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Western Australia, Australia. singarfield@meddent.uwa.edu.au
authors.forename: S L
authors.initials: SL
authors.lastname: Ingarfield
authors.forename: A
authors.initials: A
authors.lastname: Celenza
authors.forename: I G
authors.initials: IG
authors.lastname: Jacobs
authors.forename: T V
authors.initials: TV
authors.lastname: Riley
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004632:Emergency Medical Services; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D013183:Sputum / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D014904:Western Australia / Q000453:epidemiology