Table 3.
Microbiological aetiology of non-ventilator-associated hospital-acquired pneumonia (nvHAP)
| Sputum, tracheal aspirate or upper respiratory tract specimen | ‘Good quality’ sputum, tracheal aspirate or upper respiratory tract specimen (i.e. SEC <10/LPF) | Bronchoalveolar lavage, endobronchial aspirate, tissue sample | Blood culture, antigen detection in blood or urine | Any microbiological sampling method | |
|---|---|---|---|---|---|
| Number of patients sampled (% of all patients with nvHAP) | 123 (48) | 123 (48) | 10 (4) | 191 (76) | 215 (84) |
| Number of patients (% of sampled patients) | |||||
| Bacterial pneumonia (including pneumonia with oral flora) | 81 (66) | 39 (32) | 4 (40) | 13 (7) | 90 (42) |
| Gram-positive bacteria: | 17 (14) | 6 (5) | 3 (33) | 4 (2) | 22 (10) |
| Staphylococcus aureus | 11 (9) | 4 (3) | 0 | 3 (2) | 12 (6) |
| Streptococcus pneumoniae | 1 (1) | 0 | 0 | 1 (1) | 2 (1) |
| Streptococci, other than Streptococcus pneumoniae | 3 (2) | 0 | 0 | 0 | 3 (1) |
| Enterococci | 9 (7) | 4 (3) | 2 (20) | 0 | 11 (5) |
| Other gram-positivea | 0 | 0 | 1 (10) | 0 | 1 (0) |
| Enterobacteriaceae: | 32 (26) | 11 (9) | 2 (20) | 4 (2) | 34 (16) |
| Escherichia coli | 11 (9) | 5 (4) | 1 (10) | 2 (1) | 14 (7) |
| Klebsiella pneumoniae | 9 (7) | 2 (2) | 1 (10) | 1 (1) | 11 (5) |
| Klebsiella oxytoca | 4 (3) | 2 (2) | 0 | 0 | 4 (2) |
| Serratia marcescens | 5 (4) | 2 (2) | 1 (10) | 1 (1) | 6 (3) |
| Enterobacter sp. | 8 (7) | 2 (2) | 0 | 0 | 8 (4) |
| Other Enterobacteriaceaeb | 7 (6) | 8 (7) | 0 | 0 | 7 (3) |
| Non-Enterobacteriaceae bacilli | 18 (15) | 11 (9) | 5 (3) | 21 (10) | |
| Pseudomonas aeruginosa | 8 (7) | 5 (4) | 0 | 5 (3) | 13 (6) |
| Stenotrophomonas maltophilia | 3 (2) | 2 (2) | 0 | 0 | 3 (1) |
| Other non-Enterobacteriaceae bacillic | 7 (6) | 0 | 0 | 0 | 7 (3) |
| Oral flora, no other pathogen | 24 (20) | 14 (11) | 0 | 0 | 24 (11) |
| Polymicrobial pneumoniad | 25 (20) | 11 (9) | 0 | 0 | 25 (12) |
| Non-bacterial pathogens | |||||
| Viral pathogense | 12 (10) | 1 (10) | 0 | 13 (6) | |
| Aspergillus sp | 0 | 0 | 1 (10) | 2 (1) | 3 (1) |
LPF, low-power field; SEC, squamous epithelial cells.
a
Coagulase-negative staphylococci.
b
Citrobacter sp., Morganella morganii.
c
Moraxella catharalis, Haemophilus sp.
d
More than one pathogen detectable in sample(s), oral flora not considered relevant if other pathogen detectable.
e
Rhinovirus (n = 5), coronavirus (n = 2), metapneumovirus (n = 2), adenovirus (n = 1), herpes simplex virus (n = 1), parainfluenzavirus (n = 1), respiratory syncytial virus (n = 1).