Seven-year study of bacteraemic pneumonia in a single institution

In order to enhance current knowledge of nosocomial and community-acquired bacteraemic pneumonia in a single tertiary hospital in Israel, a 7-year stu dy was conducted. Using a computerised database, all patients who had bacte raemic pneumonia from March 1988 to August 1995 were studied. During the st udy period, pneumonia was the source of bacteraemia in 319 of 4,548 (7%) ep isodes, occurring in 295 patients; 211 (66%) episodes were community-acquir ed and 108 (34%) were nosocomial. The microoroganisms isolated most frequen tly from patients with community-acquired bacteraemic pneumonia were Strept ococcus pneumoniae (46%), Staphylococcus aureus (10%) and Haemophilus influ enzae (8%); while Pseudomonas spp. (17%), Klebsiella spp. (11%) and Staphyl ococcus aureus (10%) were isolated most often from the patients with nosoco mial bacteraemic pneumonia. The median age of patients was 68 years (range, 0.003-100). The overall mortality was 34%. No significant difference was f ound between the mortality rates of patients with community-acquired (31%) and nosocomial (40%) bacteraemic pneumonia (P=0.1). Multivariate analysis s howed that hypothermia, respiratory failure, impaired consciousness, trache al intubation, Staphylococcus aureus aetiology, septic shock, inappropriate empiric antibiotic treatment and age significantly increased mortality.