Title: Clinical and Bacteriological Profile of Patients Admitted to ICU with Community Acquired Pneumonia in a Tertiary Care Centre
Authors: Dr Mahendra M, Dr Mohan Kumar C K
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.30
Abstract
Introduction: Community acquired pneumonia (CAP) causes significant mortality and morbidity all over the world, especially in developing countries like India. There is scarce data on the bacteriological profile in patients admitted to ICU from South India so it is necessary to study the clinical and bacteriological profile of these patients for better understanding and treatment of pneumonia.
Methodology: We conducted a prospective study in department of Pulmonology in a tertiary care centre during October to December 2017. Consecutive patients admitted with community acquired pneumonia (CAP) were included in the study after obtaining informed consent. Patients with Hospital acquired pneumonia, Health care associated pneumonia were excluded from the study. All patients were interviewed with questionnaire, which included demographic data, risk factors like smoking and alcoholism, comorbidities, number of admissions, emergency visits, use of intravenous or oral antibiotics in past, respiratory past medical history such as COPD, bronchiectasis and asthma.
Results: 70 patients were included into study. Mean age of the cohort was 42.5±10.2 years and 45 (64.28%) of them were men. More than half the populations (52%) were chronic smokers. COPD (20%) was the most common comorbidity. Of 70 patients, 15(21.4%) patients needed invasive mechanical ventilation, 12% needed inotropes and 10% needed non-invasive ventilation. We could identify causative organisms in around 52.8% of patients. Pseudomonas aeruginosa (12/37) was the most common organisms isolated. We found that Pseudomonas aeruginosa had high resistance to Levofloxacin (94%), Azithromycin (90%), Amikacin (40%) and Pipercillin-Tazobactum(40%).
Conclusion: We found in our study gram negative organisms to be most common organisms causing CAP. Pseudomonas aeruginosa was the most common organism isolated in patients admitted to ICU with CAP. We also observed high rate of resistance to commonly used antibiotics.