gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Bacterial airway colonizations and nosocomial pneumonia in a single neurosurgical intensive care unit

Bakterielle Atemwegskolonisationen und nosokomiale Pneumonien in einer neurochirurgischen Intensivstation

Meeting Abstract

  • corresponding author T. Kral - Department of Neurosurgery, University of Bonn
  • A. Aliashkevich - Department of Neurosurgery, Wellington Hospital, New Zealand
  • E. Hoffmann - Department of Neurosurgery, University of Bonn
  • G. Marklein - Institute for Medical Microbiology and Immunology, University of Bonn
  • C. Schaller - Department of Neurosurgery, University of Bonn

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 02.23

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Kral et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: In order to enhance current knowledge of nosocomial bacterial pneumonia in a single neurosurgical intensive care unit, a prospective study was conducted.

Methods: We evaluated upper and lower airway colonization patterns with or without the development of early (day 0 – 4 of ICU stay) or late (> day 4 of ICU stay) pneumonia in 113 patients. The incidence rates of microorganisms identified in upper and/or lower airway according to the types of pneumonia were studied. Swabs were taken twice a week with follow-up until discharge.

Results: Compared to 52 patients without pneumonia (group I), 45 patients developed an early onset (group II) and 16 patients a late onset (group III) pneumonia. A significant (p<0.01) longer ICU-stay (group I: 11.0 days; group II: 16.2 days; group III: 19.6 days) and a prolonged ventilation (group I: 7.2 days; group II: 12.0 days; group III: 15.0 days) were associated with pneumonia. The most important colonizations in the upper and and lower airways were Enterobakteriaceae (group B), Enterococci/non-hemolytic Streptococci (group D), Staphylococcus aureus (group G), coagulase-negative Staphylococci/Corynebacteria (group H) and Candida types (group L). The colonization rates of the upper airways were 27% - 54% in group I patients (no pneumonia), 22% - 69% in group II patients and 50% - 88% in group III patients. A significant difference of colonization rates with microorganisms of groups D, G and H was found in the lower airways with colonization rates of 21% - 29% in patients without pneumonia versus 44% - 56% in patients with late onset pneumonia.

Conclusions: Nosocomial early and late onset pneumonia were associated with duration of ICU stay and long-term ventilation. The upper airways seem to represent an important reservoir for lower airway colonization and nosocomial pneumonia in neurosurgical ICU patients.