TY - JOUR T1 - Hospitalizations for pneumonia caused by gram-negative agents JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2558 AU - Catarina Ferreira AU - Catarina Dias AU - Teresa Costa AU - Fernando Barata Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2558.abstract N2 - Pneumonia by Gram-negative bacteria responds for 40-45% of nosocomial pneumonia (NP) and less than 10% of community-acquired pneumonia (CAP). In recent years more aggressive Gram-negative agents have emerged.Objective: Characterize hospitalizations for pneumonia by Gram-negative agents.Methods: Retrospective analysis of pneumonia with Gram-negative bacilli isolation, from January 2010 to December 2011. Evaluated demographics, co-morbidities, microbiological, radiological, treatment and outcomes.Results: Included 80 patients, 69% male, mean age 74.5 (±13.8) yrs, 74% admitted from home, 98% with comorbidities, the most common being chronic pulmonary disease (63%). Regarding the classification of pneumonia, 58% were NP, 23% related to health care and 19% CAP. Chest radiography showed multifocal involvement in 68% and bilateral in 40%. Identified 111 Gram-negative, 83% in sputum culture, the most frequent Klebsiella pneumoniae (27%), followed by Pseudomonas aeruginosa (18%) and Acinetobacter baumannii (17%). K. pneumoniae predominated in NP (28%) and associated with health care (27%), while in CAP was P. aeruginosa (26%). Gram-positive concomitant infection in 48%, 90% of these by Staphylococcus aureus methicillin-resistant. Initial antibiotics were empirically changed in 10% and adjusted according to the identified isolate in 58%. Respiratory failure requiring invasive ventilation in 4%, pleural effusion in 11% and atelectasis in 6%. The average hospital stay was 23.6 (±16.9) days. The mortality rate was 26%.Conclusion: Pneumonia by Gram-negative was nosocomial in most, occurred in individuals with advanced age and comorbidities, including chronic respiratory disease, with prolonged hospital stay and high mortality rates. ER -