Enterobacter species have not been well recognized as important lower respiratory tract pathogens. We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum cultures. The infections were usually nosocomial, and were fatal in five patients. Our patients were old (mean age 65 +/- 12.3 years) with chronic obstructive pulmonary disease (COPD) as a common underlying disease. Enterobacter species are important pathogens causing nosocomial pneumonias, especially in elderly patients with COPD.
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