Community-acquired pneumonia and nursing home-acquired pneumonia in the very elderly patients.
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.
Maruyama
Takaya
T
Department of Pulmonary and Critical Care Medicine, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu City, Mie Prefecture, Japan.
Gabazza
Esteban C
EC
Morser
John
J
Takagi
Takehiro
T
D'Alessandro-Gabazza
Corina
C
Hirohata
Shizu
S
Nakayama
Sei
S
Ramirez
Alexis Y
AY
Fujiwara
Atsushi
A
Naito
Masahiro
M
Nishikubo
Kimiaki
K
Yuda
Hisamichi
H
Yoshida
Masamichi
M
Takei
Yoshiyuki
Y
Taguchi
Osamu
O
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