Presentation, etiology and outcome of pneumonia in younger nursing home residents

Benjamin Klapdor, Santiago Ewig, Tom Schaberg, Gernot Rohde, K. Dalhoff, Hartwig Schütte, T. Welte, S. Kreuger, D. Stolz, N. Suttorp, H. Scheutte, A. Tessmer, P. Martus, T. Bauer, J. Hecht, W. Pankow, A. Lies, D. Thiemig, B. Hauptmeier, D. WedeM. Suermann, S. Ewig, M. Prediger, K. Zobel, T. Welte, M. Pletz, J. Rademacher, G. Barten, L. Gosman, W. Kreoner, R. Bals, K. Dalhoff, P. Heyer, G. G. Rohde, W. Petermann, H. Buschmann, R. Kreoning, Y. Aydin, T. Schaberg, I. Hering, R. Marre, C. Schumann, H. von Baum, T. Illmann, M. Wallner, O. Burghuber, G. Rainer

11 Citations (Scopus)


Objective: Nursing home-acquired pneumonia characteristically affects elderly patients with multiple comorbidities; it is associated with multidrug-resistant (MDR) pathogens and a high mortality. We studied the specific impact of age on the presentation, etiology and outcome of patients with NHAP. Methods: Data from the prospective multicenter CAPNETZ database were used for a comparison of the hospitalized younger nursing home residents with pneumonia to those aged ≥ 65 years as regards clinical presentation, comorbidity, severity at presentation, etiology, and outcome. Results: Amongst 618 patients with NHAP, 16% of patients (n = 100) were aged; 65 years. Comorbidity was present in most patients with NHAP but the pattern of comorbidity differed significantly. The rate of potential MDR pathogens was low among both age groups (together around 5%). According to the CRB-65 score, NHAP presentation was less severe in the younger patients. Short- and long-term mortality was twice as low in the younger patients with rates of 12.9% vs 26.6%, and 24.3% vs 43.8%, p = 0.014 and 0.002), respectively. In contrast, the usage of mechanical ventilation was more than two-fold higher (12% vs 5%) (p = 0.008) in younger patients. Antimicrobial treatment strategies did not account for different outcomes. Conclusions: A considerable proportion of patients with NHAP are: 65 years of age. They differ from older patients in terms of clinical presentation, frequency and type of comorbidity, as well as outcome. NHAP is a heterogeneous entity, with age and comorbidity as the main determinant of NHAP characteristics.

Original languageEnglish
JournalJournal of Infection
Issue number1
Pages (from-to)32-38
Number of pages7
Publication statusPublished - 01.07.2012


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