Bacteriological and clinical profile of Community acquired pneumonia in hospitalized patients

Abstract

The aim of our study was to obtain comprehensive insight into the bacteriological and clinical profile of community-acquired pneumonia requiring hospitalization. The patient population consisted of 100 patients admitted with the diagnosis of community-acquired pneumonia (CAP), as defined by British Thoracic society, from December 1998 to Dec 2000, at the Sher- i-Kashmir institute of Medical Sciences Soura, Srinagar, India. Gram negative organisms were the commonest cause (19/29), followed by gram positive (10/29). In 71 cases no etiological cause was obtained. Pseudomonas aeruginosa was the commonest pathogen (10/29), followed by Staphylococcus aureus (7/29), Escherichia coli (6/29), Klebsiella spp. (3/29), Streptococcus pyogenes (1/29), Streptococcus pneumoniae (1/29) and Acinetobacter spp. (1/29). Sputum was the most common etiological source of organism isolation (26) followed by blood (6), pleural fluid (3), and pus culture (1). Maximum number of patients presented with cough (99%), fever (95%), tachycardia (92%), pleuritic chest pain (75%), sputum production (65%) and leucocytosis (43%). The commonest predisposing factors were smoking (65%), COPD (57%), structural lung disease (21%), diabetes mellitus (13%), and decreased level of consciousness following seizure (eight per cent) and chronic alcoholism (one per cent). Fourteen patients, of whom, nine were males and five females, died. Staphylococcus aureus was the causative organism in four, Pseudomonas in two, Klebsiella in one, and no organism was isolated in seven cases. The factors predicting mortality at admission were - age over 62 years, history of COPD or smoking, hypotension, altered sensorium, respiratory failure, leucocytosis, and staphylococcus pneumonia and undetermined etiology. The overall rate of identification of microbial etiology of community-acquired pneumonia was 29%, which is very low, and if serological tests for legionella, mycoplasma and viruses are performed the diagnostic yield would definitely be better. This emphasizes the need for further studies (including the serological tests for Legionella, mycoplasma and viruses) to identify the microbial etiology of CAP.

Factors predicting in‐hospital mortality among patients admitted with community acquired pneumonia at a tertiary care hospital Karachi, Pakistan

“…This is similar to previous published data from our hospital in 2013 13 and also similar to India where the most common isolated organisms reported were Pseudomonas aeruginosa and Staphylococcus aureus. 20 The incidence of Streptococcus pneumoniae is slightly lower in our population compared to western world where it was associated with significant mortality. 8,21 Viruses are also commonly isolated in CAP.…”

Etiology and outcome of severe community acquired pneumonia in immunocompetent adults

“…Another study in Russia found Staphylococcal aureus and Pseudomonas aeruginosa to be important etiological agents in SCAP [19]. On the contrary in the Asian continent, the most common organisms isolated in patients from India were Pseudomonas aeruginosa (35%) and Staphylococcus aureus (24%) [20]. A relatively higher prevalence of Pseudomonas aeruginosa and Staphylococcus aureus has also been reported in Japan and China [21-24] indicating microbiological spectrum specific to certain epidemiological areas.…”

Etiology and anti-microbial sensitivity of organisms causing community acquired pneumonia: A single hospital study

“…[9] The IDSA has adopted the new antipneumococcal fluoroquinolones, namely levofloxacin, sparfloxacin, moxifloxacin and gatifloxacin, as preferred agents for the treatment of both ambulatory and hospitalized patients with CAP and for penicillin-resistant pneumococcal pneumonia. [10] For empiric treatment of the moderately ill-hospitalized patient, the IDSA recommends an extended-spectrum cephalosporin (cefotaxime, ceftriaxone) plus a macrolide or monotherapy with a fluoroquinolone.…”