Tuberc Respir Dis.  1995 Feb;42(1):67-75. 10.4046/trd.1995.42.1.67.

Etiologies of Bacterial Pneumonia with Implications for Therapy

• Woo J
• Lee JS
• Kwon KH
• Kim KH
• Choi CH
• Park C
• Lee WG
• Choi TY

• KMID: 2045054
• DOI: http://doi.org/10.4046/trd.1995.42.1.67

Abstract

BACKGROUND
Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications.
METHODS
A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated.
RESULTS
1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(ll%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methiciilin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%.
CONCLUSION
As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

Keyword

Bacterial pneumonia; Etiology; Antimicrobial susceptibility

MeSH Terms

Acinetobacter
Amikacin
Anti-Bacterial Agents
Aztreonam
Carbenicillin
Chloramphenicol
Ciprofloxacin
Drug Resistance, Microbial
Enterobacter
Gentamicins
Gram-Positive Cocci
Klebsiella
Klebsiella pneumoniae
Mortality
Piperacillin
Pneumonia
Pneumonia, Bacterial*
Pseudomonas
Retrospective Studies
Sputum
Staphylococcus
Streptococcus pneumoniae
Amikacin
Anti-Bacterial Agents
Aztreonam
Carbenicillin
Chloramphenicol
Ciprofloxacin
Gentamicins
Piperacillin