Lung

, Volume 189, Issue 6, pp 475–483

Characterization of Enterobacter cloacae Pneumonia: A Single-Center Retrospective Analysis

  • Jan K. Hennigs
  • Hans Jörg Baumann
  • Stefan Schmiedel
  • Pierre Tennstedt
  • Ingo Sobottka
  • Carsten Bokemeyer
  • Stefan Kluge
  • Hans Klose
Article

DOI: 10.1007/s00408-011-9323-2

Cite this article as:
Hennigs, J.K., Baumann, H.J., Schmiedel, S. et al. Lung (2011) 189: 475. doi:10.1007/s00408-011-9323-2

Abstract

Objectives

Enterobacter cloacae (E. cloacae) is a Gram-negative rod commonly found on intensive care units (ICU) causing severe infections with high mortality. Specific characteristics of E. cloacae pneumonia, however, have not been identified.

Design

Evaluation of clinical and microbiological records of patients with positive respiratory samples for E. cloacae was performed by a 1-year retrospective study in a large university hospital.

Results

Ninety-seven of 115 eligible patients with E. cloacae-positive respiratory samples developed pneumonia. Patients were predominantly male (68%), older (median age = 62 years), and immunodeficient (54%). Seventy-eight percent required ICU admission, of which 97% required mechanical ventilation. Ventilator-associated pneumonia (VAP) occurred in 58%. Those who developed E. cloacae VAP had undergone twice as many surgical procedures under translaryngeal intubation prior to VAP onset (89 vs. 48%, P < 0.0001). Overall, E. cloacae VAP mortality was 24%. In E. cloacae VAP patients, presence of translaryngeal tubes (P = 0.02) and female gender (P = 0.0003) were associated with poor survival. Multivariate analysis confirmed male sex as a protective factor (relative risk: 0.39; P = 0.007).

Conclusion

Enterobacter cloacae causes VAP with high mortality, predominantly in women. Risk factors for E. cloacae pneumonia seem to match those for VAP. The presence of translaryngeal endotracheal tubes seems to be the specific factor for E. cloacae VAP.

Keywords

VAP Infection Mechanical ventilation Critical care Enterobacteriaceae Outcome Risk factors 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jan K. Hennigs
    • 1
    • 5
  • Hans Jörg Baumann
    • 1
    • 5
  • Stefan Schmiedel
    • 2
  • Pierre Tennstedt
    • 3
  • Ingo Sobottka
    • 4
  • Carsten Bokemeyer
    • 1
  • Stefan Kluge
    • 5
  • Hans Klose
    • 1
  1. 1.Department of Internal Medicine II—Oncology, Haematology, BMT with Section PneumologyUniversity Medical Centre Hamburg—EppendorfHamburgGermany
  2. 2.Department of Internal Medicine I—Bernhard Nocht Hospital for Tropical MedicineUniversity Medical Centre Hamburg—EppendorfHamburgGermany
  3. 3.Department of PathologyUniversity Medical Centre Hamburg—EppendorfHamburgGermany
  4. 4.Department of Medical Microbiology, Virology and HygieneUniversity Medical Centre Hamburg—EppendorfHamburgGermany
  5. 5.Department of Critical Care MedicineUniversity Medical Centre Hamburg—EppendorfHamburgGermany

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