A clinical study of Pseudomonas pneumonia diagnosed by transtracheal aspiration

Abstract

We performed a clinical study of 16 cases (18 episodes) of Pseudomonas pneumonia by transtracheal aspiration (TTA) from April 1983 to March 1993. The isolation rate of Pseudomonas aeruginosa (P. aeruginosa) among 235 episodes of pneumonias with positive microorganism by TTA was 7.7%. All patients had one or more underlying disease. The most frequent underlying disease was chronic lower respiratory tract infection, followed by lung epidermoid cell carcinoma. More than half of the cases had been given antibiotics prior to the occurrence of pneumonia, and administration of adrenal corticosteroid, heavy smoking habit, and aspiration were seen as other predisposing factors concerning the onset of pneumonias. Monomicrobial infection of P. aeruginosa was 61.1%, and polymicrobial infection containing P. aeruginosa was 38.9%. Community-acquired pneumonia was 61.1% and hospital-acquired pneumonia was 38.9%; the rates of polymicrobial infections and prior administration of antibiotics were higher in the latter group. Mortality due to Pseudomonas pneumonia was 27.8% and the levels of serum albumin and total protein at the onset of pneumonia were significantly lower in the fatal cases than in the recovered cases. It was considered that not only general underlying disease which weaken the immunological resistance of the host, but local bronchial lesion was also important to the onset of the Pseudomonas pneumonia. Also, nutrition is an important prognostic factor on the host's side.