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Volume 12, Number 2—February 2006

Research

Ameba-associated Microorganisms and Diagnosis of Nosocomial Pneumonia

Pierre Berger*†, Laurent Papazian‡, Michel Drancourt*†, Bernard La Scola*†, Jean-Pierre Auffray‡, and Didier Raoult*†Comments to Author 
Author affiliations: *Centre Hospitalier Universitaire La Timone, Marseille, France; †Université de la Méditerranée, Marseille, France; ‡Hôpital Sainte-Marguerite, Marseille, France

Main Article

Table 1

Identification of 26 nonameba-associated microorganisms in 210 episodes of pneumonia

Microorganism Definite,*
no. (%) Possible,†
no. (%) Total,
no. (%)
Community-acquired pneumonia
Bacteria
Acinetobacter baumanii 2 (1.4) 2 (1.2)
Chlamydia pneumoniae 1 (3.6) 2 (1.4) 3 (1.8)
C. psittacci 1 (3.6) 2 (1.4) 3 (1.8)
Enterobacter cloacae 1 (0.7) 1 (0.6)
E. faecalis 1 (0.7) 1 (0.6)
Escherichia coli 2 (7.1) 2 (1.4) 4 (2.3)
Haemophilus influenzae 1 (3.6) 3 (2.1) 4 (2.3)
Mycobacterium tuberculosis 1 (3.6) 1 (0.6)
Pseudomonas aeruginosa 1 (3.6) 2 (1.4) 3 (1.8)
Serratia marcescens 1 (0.7) 1 (0.6)
Staphylococcus aureus 1 (3.6) 5 (3.5) 6 (3.6)
Streptococcus agalactiae 1 (0.7) 1 (0.6)
S. pneumoniae 3 (2.1) 3 (1.8)
Fungi
Pneumocystis carinii 3 (10.7) 3 (1.8)
Viruses‡
Cytomegalovirus 2 (1.4) 2 (1.2)
Herpes simplex virus 1 4 (2.8) 4 (2.3)
Ventilator-associated pneumonia
Bacteria
A. baumanii 1 (0.7) 1 (0.6)
Balneatrix alpica 1 (3.6) 1 (0.6)
C. pneumoniae 1(0.7) 1 (0.6)
Citrobacter koseri 1 (0.7) 1 (0.6)
Clostridium freundii 1 (0.7) 1 (0.6)
Coxiella burnetii 1 (0.7) 1 (0.6)
Enterobacter aerogenes 4 (2.8) 4 (2.3)
E. cloacae 5 (3.5) 5 (2.9)
E. coli 2 (7.1) 6 (4.2) 8 (4.7)
H. influenzae 1 (0.7) 1 (0.6)
Proteus mirabilis 3 (2.1) 3 (1.8)
Pseudomonas aeruginosa 9 (32.1) 31 (21.7) 40 (23.4)
Raoultella ornithinolytica 1 (0.7) 1 (0.6)
S. marcescens 2 (1.4) 2 (1.2)
S. aureus 2 (7.1) 21 (14.7) 23 (13.6)
S. epidermidis 1 (3.6) 1 (0.7) 2 (1.2)
Stenotrophomonas maltophilia 5 (3.5) 5 (2.9)
S. agalactiae 1 (0.7) 1 (0.6)
S. pneumoniae 1 (3.6) 2 (1.4) 3 (1.8)
Fungi
Candida albicans 1 (3.6) 1 (0.6)
Viruses‡
Cytomegalovirus 11 (7.7) 11 (6.4)
Herpes simplex virus 1 13 (9.1) 13 (7.6)
Total 28 (100.0) 143 (100.0) 171 (100.0)

*Detection of M. tuberculosis or P. carinii by bronchioalveolar lavage (BAL); simultaneous positive culture with BAL and blood culture; positive for influenza viruses A and B, adenovirus, or C. burnetii (immunoglobulin G2 [IgG2] titer >1:200, IgM2 >1:50); 4-fold increase in antibody titer between acute- and convalescent-phase serum; or seroconversion from 0 to 1:128 for C. psittacci, from 0 to 1:256 for C. pneumoniae, from 0 to 1 for M. pneumoniae, and from 0 to 1:100 for B. alpica.
†Detection of a potentially pathogenic microorganism (M. tuberculosis and P. carinii) by BAL and single or stable antibody titer >1:512 for Chlamydia spp., >1:2 for M. pneumoniae, and >1:400 for B. alpica.
‡No epidemic of influenza virus A/B or adenovirus was observed during the 18-month study period.

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