title: Frequent detection of multidrug-resistant pneumonia-causing bacteria in the pneumonia lung tissues of patients with hematological malignancies.
abstract: Pneumonia is a critical issue during the agonal phase, and often becomes lethal in the absence of pathogen detection. Autopsy is a powerful tool for analyzing the cause of a patient's death, progression of the disease, and the therapeutic response. However, it is frequently limited to the identification of bacterial strains. To elucidate the pathogenesis during the agonal phase of pneumonia, intrapulmonary sputum was harvested by directly inserting a swab into a resected lung, and the bacterial composition was analyzed using both pathological and microbiological techniques from 15 patients with hematological malignancies, and the results were compared with those from 25 patients with other medical and surgical diseases. Among the 54 bacteria strains isolated from the 40 patients, multidrug-resistant strains were significantly more prevalent in hematological group than in other diseases (16/21 versus 11/33, P = .002). Enterococcus faecium was preferentially isolated from the hematological patients, whereas the methicillin-resistant Staphylococcus aureus was predominantly found in the nonhematological group. Two coagulase-negative Staphylococcus epidermidis strains in hematological diseases may be diagnosed as causative bacteria of pneumonia by both bacterial and pathological techniques. Although the results of this study may not be directly applicable for clinical diagnosis, this approach has a potential to become not only a diagnostic method for bacterial pneumonia, but may be also useful for the analysis of multidrug-resistant pathogens.
authors.affiliation: Division of Molecular Pathology, University of Fukui, Fukui, Japan. kinai@u-fukui.ac.jp
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Inai
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Sakon
authors.initials: S
authors.lastname: Noriki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikegaya
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamashita
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Imamura
authors.forename: Nobuo
authors.initials: N
authors.lastname: Takimoto
authors.forename: Hisataka
authors.initials: H
authors.lastname: Kato
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.forename: Hironobu
authors.initials: H
authors.lastname: Naikia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D001706:Biopsy; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D013183:Sputum / Q000382:microbiology*