Bacteriologic and Histopathologic Correlation in Terminal Pneumonia in the Aged

Abstract

In order to determine causative organisms in terminal pneumonia in the aged, 90 autopsies were made during the period from July 1979 to September 1982. The results of routine bacteriological cultures from the lung were analyzed with respect to the correlation between bacteriologic and histologic findings. The following results were obtained.
1) One hundred and twenty strains were isolated from 54 culture positive cases. K. pneumoniae, S. faecalis, E. coli and P. aeruginosa were the more frequently isolated strains of bacteria. Gram-negative bacilli were apparent in 63% of 120 strains.
2) It was very difficult to assess causative organisms of terminal pneumonia from the bacteria isolated in antemortem sputum.
3) The cases showing bacterial amounts of (+) or more isolated from the postmortem lung have greater likelihood of pneumonia as a cause of death.
4) Forty-eight strains were isolated from 30 terminal pneumonia cases. In terms of bacterial amount, K. pneumoniae, glucose non-fermentative gram-negative bacilli, S. aureus, and E. coli were most frequently isolated.
5) The incidence of positive cultures in alveolar pneumonia was significantly higher than that of mixed-type pneumonia.