Clinical study
The bacteriology of aspiration pneumonia

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Abstract

A prospective study of 54 cases of pulmonary infection following aspiration was performed. Specimens utilized for bacteriologic study were either transtracheal aspirates, empyema fluid or blood. Appropriate anaerobic bacteriologie methods were employed. Anaerobic bacteria were recovered in 50 patients (93 per cent) and were the only pathogens in 25 (46 per cent). The predominant species were Bacteroides melanino-genicus, Fusobacterium nucleatum and anaerobic or microaerophilic gram-positive cocci. Bacteroides fragilis, which is resistant to many commonly used antibiotics, was recovered in nine patients (17 per cent). Aerobic and facultative bacteria were present in 29 patients (54 per cent), but anaerobes were present concurrently in all but 4. Enteric gram-negative bacilli and pseudomonads were particularly common in patients whose disease developed in the hospital. Eleven patients with mixed aerobic and anaerobic infections were treated successfully with antibiotics which were active only against the anaerobic isolates, thereby further implicating the pathogenic role of these microorganisms. The results indicate that anaerobes play a key role in most cases of infection following aspiration.

References (60)

  • DL Leake

    Bacteroides osteomyelitis of the mandible

    Oral Surg

    (1972)
  • SM Finegold

    Isolation of anaerobic bacteria

  • Outline of Clinical Methods in Anaerobic Bacteriology

    (1972)
  • WJ Martin et al.

    In vitro antimicrobial susceptibility of anaerobic bacteria isolated from clinical specimens

    Antimicrob Agents Chemother

    (1972)
  • TD Wilkins et al.

    Standardized single-disc method for antibiotic susceptibility testing of anaerobic bacteria

    Antimicrob Agents Chemother

    (1972)
  • JG Bartlett et al.

    Treatment of anaerobic infections with lincomycin and clindamycin

    N Engl J Med

    (1972)
  • GA Culver et al.

    Frequency of aspiration of gastric contents by the lungs during anesthesia and surgery

    Ann Surg

    (1951)
  • JB Amberson

    Aspiration bronchopneumonia

    Int Clin

    (1937)
  • WV Hamelberg et al.

    Aspiration pneumonitis

  • DE Dines et al.

    Aspiration pneumonitis

  • WC Awe et al.

    The pathophysiology of aspiration pneumonitis

    Surgery

    (1966)
  • MW Lincoln

    Aspiration of gastric contents under anesthesia

    Calif Med

    (1957)
  • LD Vandam

    Medical intelligence—current concepts. Aspiration of gastric contents in the operative period

    N Engl J Med

    (1965)
  • JL Cameron et al.

    Aspiration pneumonia—Clinical outcome following documented aspiration

    Arch Surg

    (1973)
  • WK Bannister et al.

    Vomiting and aspiration during anesthesia

    Anesthesiology

    (1962)
  • AM Olsen

    The spectrum of aspiration pneumonitis

    Ann Otol Rhinol Laryngol

    (1970)
  • JL Cameron et al.

    Aspiration pneumonia — magnitude and frequency of the problem

    JAMA

    (1972)
  • HA Anderson et al.

    Pulmonary complications of cardiospasm

    JAMA

    (1953)
  • NR Barrett

    Association of esophageal and pulmonary disease

    Postgrad Med

    (1964)
  • S Moallem et al.

    Pulmonary complications of gastroesophageal reflux

    NY State J Med

    (1973)
  • Cited by (0)

    1

    From the Infectious Disease Section, Veterans Administration Hospital, Sepulveda, California; Wadsworth Hospital Center, Veterans Administration, Los Angeles, California; and the Department of Medicine, UCLA School of Medicine, Los Angeles, California.

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