Etiology and clinical profile of inpatients with Community acquired pneumonia in Manipal Teaching hospital, Pokhara, Nepal

Shrestha, Rajani; Paudel, Naba R.; Barakoti, B; Dhungana, Durga; Sharma, Puneet

doi:10.3126/njms.v1i2.6605

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…In the present study it is found that streptococcal pneumoniae being more common pathogen in CAP accounting for 36%. Next common is Pseudomonas aeruginosa which accounts for 18% followed by Staphylococcus aureus 12%, Klebsiella constituted about 8%., E. coli 6% and H. influenza 4% This observation is similar to that of study done by Shrestha R et al 8 and Vishak K. Acharya, Mahesha Padyana and others. 9…”

Section: Discussionsupporting

confidence: 91%

Clinical and Bacteriological Profile of Community Acquired Pneumonia among Adult Patients

Joseph¹,

K²

2019

jemds

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BACKGROUND Community acquired pneumonia is an acute illness acquired in the community with symptoms suggestive of LRTI. Pneumonia is one of the leading causes of death and morbidity, both in developing and developed countries and is the commonest cause of hospitalization in adults and children. We wanted to assess the clinical and bacteriological presentation of CAP. METHODS This is a cross sectional study conducted among 50 patients. Both out patients and inpatients of the Department of Pulmonology were included in the study. Pretested and predesigned proforma is used to collect the data. Analysis was carried out in statistical software SPSS Ver. 19.0. RESULTS 76% of CAP patients are males of which 58% were elderly (>50 yrs.). The study group consisted of 50 patients among whom 38 (76%) were males and 12 (24%) were females. Dyspnoea is significantly more common among elderly CAP patients and chest pain more common among in younger CAP patients. S. pneumoniae being more common pathogen in CAP accounting for 38%. CONCLUSIONS In our study, CAP was found more commonly between 3 rd and 5 th decade of life with a male:female ratio of 3.1:1. Most common presenting symptoms were cough with expectoration and fever. Streptococcus pneumoniae was the commonest organism isolated followed by Pseudomonas aeruginosa and Staphylococcus aureus.

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Section: Discussionsupporting

confidence: 91%

Clinical and Bacteriological Profile of Community Acquired Pneumonia among Adult Patients

Joseph¹,

K²

2019

jemds

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“…3 In a review of pneumococcal disease rates in Asia, the most common co-morbidities included bronchopulmonary disease, cardiovascular disease, malignancy, and diabetes mellitus 3. In Nepal, lung disease is extremely prevalent; chronic obstructive pulmonary disease [COPD] alone accounts for 43% of the adult non-communicable disease burden in Nepal4 and was the most common comorbidity in a study of patients with community acquired pneumonia in a tertiary hospital in western Nepal 5. Indoor air pollution, dust exposure, recurrent infections, and high cigarette smoking rates all contribute to the high lung disease burden in Nepal 6–8…”

Section: Problemmentioning

confidence: 99%

Improving pneumococcal vaccination rates of medical inpatients in urban Nepal using quality improvement measures

Bock

Chintamaneni

Rein

et al. 2016

BMJ Qual Improv Report

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Streptococcus pneumoniae infection is associated with high morbidity and mortality in low income countries. In Nepal, there is a high lung disease burden and incidence of pneumonia due to multiple factors including indoor air pollution, dust exposure, recurrent infections, and cigarette smoking. Despite the ready availability of effective pneumococcal vaccines (PNV), vaccine coverage rates remain suboptimal globally. Quality Improvement (QI) principles could be applied to improve compliance, but it is a virtually new technology in Nepal.This QI study for Patan Hospital sought to introduce the concept of QI there, to measure the baseline pneumococcal vaccination rate of qualifying adult patients discharged from the medical wards and to assess reasons for non-vaccination. QI interventions were instituted to improve this rate, measuring the effectiveness of QI methods to produce the desired outcomes using the Model for Improvement, Plan-Do-Study-Change (PDSA) methodology.In the three week baseline assessment, 2 out of 81 (2%) eligible patients recalled ever receiving a prior pneumococcal vaccine; 68 (84%) unvaccinated patients responded that they were not asked or were unaware of the PNV. After the QI interventions, the pneumococcal vaccination rate significantly increased to 42% (23/56, p<0.001). Post-intervention, the leading reason for non-vaccination was cost (20%, 11/56). Only 5 (9%) unvaccinated patients were not asked or were unaware of the PNV, a significant change in that process outcome from baseline (p<0.001).Quality improvement measures were effective in increasing pneumococcal vaccination rates, despite the limited familiarity with QI methods at this major teaching hospital. QI techniques may be useful in this and other efforts to improve quality in resource-limited settings, without great cost.

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“…Another study even found 76% unidentified CAP specimens. (20) The Most of the CAP-causing bacteria found in our specimens were dominated by Gram-negative bacteria, such as Klebsiella pneumoniae 32 isolates (29.6%), and Acinetobacter baumanii 11 isolates (10.2%) from a total of 108 isolates. Another study that was performed in Persahabatan Hospital also found mostly Gramnegative bacteria, such as Klebsiella pneumoniae (34%) and Acinetobacter baumanii (19.1%) as the CAP-causing pathogen (21), and a study in Semarang found Klebsiella pneumoniae (14%) and Streptococcus pneumoniae 13% as the most CAP-causing pathogens (6).…”

Section: Figure 1 Workflow Of Afb Staining Performed Using Ziehl-neementioning

confidence: 78%

“…Different results were showed by another studies, who found Streptococcus pneumoniae as the highest pathogen causing CAP, ranged from 15-38% while Streptococcus pneumoniae was only found 1.9% from all cases (7,9,20,(24)(25)(26), suggested that different culture media contributed to different bacterial description. In our study, gentamicin blood agar was not performed due to cost limit.…”

Section: Figure 1 Workflow Of Afb Staining Performed Using Ziehl-neementioning

confidence: 82%

Epithelial Cells Count and the Ratio of Leukocytes and Epithelial Cells as the Criteria to Determine Qualified Specimen for Community-Acquired Pneumonia (CAP)-causing Pathogens Identification

et al. 2020

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BACKGROUND: Community-acquired pneumonia (CAP) is the most common infectious with serious rate of morbidity and mortality. Recent conventional method only described 30-50% of CAP etiology. Sputum specimen quality assessment is important to obtain an accessible CAP-causing pathogens identification.METHODS: This was a prospective descriptive study involving 100 specimens from CAP-diagnosed subjects in Budhi Asih Regional General Hospital inpatien tcare. We assessed three gram-staining criteria for specimen quality determination, and continued by bacterial identification.RESULTS: All specimens were qualified according to criteria II, while only 94 and 96 specimens were qualified according to criteria I and III, respectively. Sixty-five specimens could be identified by culture and pneumoCLART polymerase chain reaction (PCR) examination, and the 35 specimens remained unknown. Ten out of those 35 specimens were positive after analyzed by Acid-fast Bacilli (AFB) test. The pathogens we identified including Klebsiella pneumoniae (29.6%), Acinetobacter baumanii (10.2%), Enterobacter cloacae (4.6%), Pseudomonas aeruginosa (4.6%), Staphyloccocus aureus (4.6%), Moraxella catarrhalis (3.7%), Enterobacter aerogenes (2.8%), Escherichia coli (2.8%), Streptococcus pneumoniae (1.9%), Mycoplasma pneumoniae (1.9%) and Citrobacter koseri (0.9%).CONCLUSION: There were no significant differences among the three criteria for sputum specimen quality assessment, based on culture and pneumoCLART examination. We suggest that criteria II could be used to avoid many specimen rejections while good quality specimens still attained for accessible bacteria identification.KEYWORDS: community-acquired pneumonia, sputum, gram stain, pathogens, bacteria

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Etiology and clinical profile of inpatients with Community acquired pneumonia in Manipal Teaching hospital, Pokhara, Nepal

Cited by 7 publications

References 13 publications

Clinical and Bacteriological Profile of Community Acquired Pneumonia among Adult Patients

Clinical and Bacteriological Profile of Community Acquired Pneumonia among Adult Patients

Improving pneumococcal vaccination rates of medical inpatients in urban Nepal using quality improvement measures

Epithelial Cells Count and the Ratio of Leukocytes and Epithelial Cells as the Criteria to Determine Qualified Specimen for Community-Acquired Pneumonia (CAP)-causing Pathogens Identification

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