PNEUMONIA IN A NURSING-HOME

The authors studied nursing home residents serologically to determine whether atypical organisms were causes of radiologic pneumonia. The st udy was conducted at the Wisconsin Veterans Home, a facility with on-s ite microbiology and x-ray. Over one year, serologic examinations for Legionella, Mycoplasma, and Chlamydia were conducted for the residents who had pneumonia. Cultures and mortality were reviewed. Fifty-six ep isodes were studied (mean resident age 78 years). There was no fourfol d titer change. Seventeen quality sputum specimens revealed Streptococ cus pneumoniae (5), normal flora (4), Hemophilus influenzae (4), Morax ella catarrhalis (3), Staphylococcus aureus (1), and beta-hemolytic St reptococcus, not group A (1). The two-month mortality was 21%. This st udy did not result in serologic confirmation of atypical organisms' ca using pneumonia. Antibiotic choice should be based on coverage of prev alent organisms, including Hemophilus influenzae, Moraxella, and Staph ylococcus, as well as clinical features.