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Bacteriology and treatment of gram-negative pneumonia in long-term hospitalized children.

Gram-negative bacillary pneumonia was diagnosed in 39 longterm hospitalized children, ranging in age from 4 months to 14 years (mean seven years). Fifteen had pneumonitis, 18 necrotizing pneumonia, and six lung abscess. An associated empyema was noted in six cases. Specimens for culture were obtained through percutaneous transtracheal aspiration. Five microorganisms were the predominant isolates: P aeruginosa (13 instances), K pneumoniae (11), E coli (7), S marcescens (6), and P mirabilis (2). There were 112 aerobic and 25 anaerobic isolates recovered from the 39 patients, accounting for 3.5 isolates per specimen. Other aerobic and or anaerobic organisms were mixed with the Gram-negative bacilli in half the patients. All patients were treated with gentamicin for 10 to 26 days (average 19.5 days), and all were cured. In 12 patients in whom other organisms resistant to gentamicin were also present, other antimicrobial agents were concomitantly administered.