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Community-Acquired Pneumonia in Adults: A Mono-Center Retrospective Study



Khorvash F1 ; Hakamifard A1 ; Sharif AE1 ; Zali MM2 ; Motamedi N3 ; Ghiasi F4 ; Sharif ME5 ; Esmaeili F4 ; Adibi A6
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Authors Affiliations
  1. 1. Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Occupational Therapy, University of Rehabilitation and Social Sciences, Tehran, Iran
  3. 3. Department of Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Internal Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Research Division of Natural Resources, Isfahan Agricultural and Natural Resources Research Center, Isfahan, Iran
  6. 6. Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Tanaffos Published:2024

Abstract

Background: Adult community-acquired pneumonia is the most common cause of hospitalization and a leading cause of death. Identification of microorganisms causing community-acquired pneumonia. Materials and Methods: A cross-sectional design was used. Information on adults hospitalized due to pneumonia in the cold seasons of 2018 and 2019 was collected. Results of microbiologic tests, other than serology and urinary antigen, were reviewed Results: 205 patients had eligible criteria. The mean age was 52.4 and 62% were male. Microorganisms were identified in 117 (57%) patients. The most common etiologic agents were Influenza H1N1 2009 (n=39, 33.4%), Tuberculosis (n=21, 17.9%), Non-Albicans Candida Yeast (n=9, 7.8%), Methicillin Resistant Staphylococcus Epidermis (n=7, 6%) and Klebsiella Pneumonia (n=5, 4.3%). Streptococcus Pneumoniae had the 6th rank (n=3, 2.6%). A higher body mass index was associated with superimposed infections. 10 of 18 (56%) patients who died in hospital, got definite microbiologic diagnoses. The maximum mortality was due to staphylococci, with methicillin-resistant strains of Staphylococcus aureus (n=2, 66%) and Staphylococcus epidermis (n=2, 29%). Conclusion: H1N1 2009 was the first cause. Tuberculosis with rising incidence could cause acute pneumonia. Pneumococcal incidence had declined. Community-acquired staphylococcal pneumonia is the most dangerous; hence, specific protocol-based treatments should be applied promptly. Community-acquired Staphylococcus epidermis and Tuberculosis must be included in differential diagnosis of the disease. Antibiotics need to be individualized in managing the obese patients. A special focus on the epidemiology of virulence factors of Klebsiella pneumoniae is needed as it is common, severe, and lethal. © 2024 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.
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