Nosocomial pneumonias in Thailand.

In order to compare the etiology, clinical manifestations, and prognosis of patients acquiring nosocomial pneumonia, we studied and compared sixty normal hosts who acquired nosocomial pneumonia during Jan 1, 1989-Dec 31, 1991 (group I) with seventy-two immunocompromised patients with nosocomial pneumonia who were admitted during 1984-1992 (group II). Both groups were similar in some patterns, eg gram-negative bacilli were common (80%, 50%), the chest roentgenogram showed initial localized lesions (74%, 72%), and there was a high mortality rate (46.7%, 54.2%). The differing findings were that the first group acquired pneumonia more often during the first 7 days after admission, transbronchial aspiration was believed to be the route of entry and most of the patients had productive coughs. Blood cultures rarely yielded the organisms (7%). The second group had pneumonia at a mean of 32 days after admission, hematogenous spread to the lungs was common and blood cultures more often yielded the etiologic organisms (41.7%).