title: Community-acquired pneumonia and nursing home-acquired pneumonia in the very elderly patients.
abstract: The rapid increase in the elderly population is leading to a corresponding increase in the number of people requiring medical care. To date no comparative study between community-acquired pneumonia (CAP) and nursing home-acquired pneumonia (NHAP) has been reported in the very elderly non-intubated patients. The present study was undertaken to compare the clinical characteristics and microbial etiology between CAP and NHAP in elderly patients >/=85-years old. There were 54 patients with NHAP and 47 with CAP. Performance status was significantly worse in the NHAP than in the CAP group. Among all patients, the most frequent pathogens were Chlamydophilia pneumoniae followed by Streptococcus pneumoniae, Mycoplasma pneumoniae influenza virus and Staphylococcus aureus. The frequency of S. peumoniae was significantly higher in NHAP patients than in CAP patients after adjusting for age and sex. Physical activity, nutrition status and dehydration were significant prognostic factors of pneumonia among all patients. In-hospital mortality was significantly higher in NHAP than in CAP after adjusting for age and sex. This study demonstrated that the etiology and clinical outcome differ between CAP and NHAP patients in the very elderly non-intubated population.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu City, Mie Prefecture, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Maruyama
authors.forename: Esteban C
authors.initials: EC
authors.lastname: Gabazza
authors.forename: John
authors.initials: J
authors.lastname: Morser
authors.forename: Takehiro
authors.initials: T
authors.lastname: Takagi
authors.forename: Corina
authors.initials: C
authors.lastname: D'Alessandro-Gabazza
authors.forename: Shizu
authors.initials: S
authors.lastname: Hirohata
authors.forename: Sei
authors.initials: S
authors.lastname: Nakayama
authors.forename: Alexis Y
authors.initials: AY
authors.lastname: Ramirez
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Naito
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Nishikubo
authors.forename: Hisamichi
authors.initials: H
authors.lastname: Yuda
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
authors.forename: Osamu
authors.initials: O
authors.lastname: Taguchi
mesh_terms: D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009177:Mycoplasma pneumoniae / Q000472:pathogenicity; D009735:Nursing Homes; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology / Q000382:microbiology*; D011023:Pneumonia, Staphylococcal / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013211:Staphylococcus aureus / Q000472:pathogenicity