Differences in etiology of pneumonias in nursing home and community patients

Abstract

Comparison of 35 elderly patients hospitalized with pneumonia acquired in nursing homes and 35 elderly patients hospitalized with community-acquired pneumonia showed that 16 (47.1%) of the nursing home patients had received previous antibiotic therapy compared with two (5.9%) of the community patients. Klebsiella pneumoniae was isolated in 14 (40%) of the nursing home patients, but in only three (8.6%) of the community patients. Staphylococcus aureus was also more frequent in nursing home patients (nine, 25.7%) compared with community patients (five, 14.3%). Persons hospitalized with nursing home-acquired pneumonia should be treated initially with antimicrobial agents active against K pneumoniae and S aureus unless the clinical picture strongly suggests otherwise.