Summary:
Introduction: Pneumonia is a worldwide, serious threat to
health and an enormous socio-economic burden for health
care system. According to recent WHO data, each year 3-4
million patients die from pneumonia. The clinical
presentations and bacterial agents responsible for community
acquired pneumonia (CAP) varies according to geography
and culture.
Methods: A cross sectional observational study conducted
among the 53 consecutive patients with a clinical diagnosis
of CAP in admitted patient in the department of Medicine,
DMCH, during January 2010 to December 2010.
Hematological measurements (TC of WBC, Hb%, ESR,
platelet count), blood culture, chest X-ray P/A view, sputum
for Gram staining and culture sensitivity, sputum for AFB,
blood urea and random blood sugar were done in all cases.
ELISA for IgM antibody of Mycoplasma pneumoniae and
Chlamydia pneumoniae were done in sputum culture
negative cases.
Results: The mean (±SD) age was 38.9±17.3 years and Male
female ratio was 3:1. Fever, chest pain and productive cough
were the most common clinical features. The mean (±SD)
respiratory rate was 23.0±2.8 /minute . COPD and DM were
found in 17.0% and 5.7% of patients respectively . Blood
culture was found positive in only 1.9% of the study patients.
Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%,
mixed Gram positive cocci and Gram negative bacilli 11.32%
and Gram negative Cocco Bacilli 1.9% were observed and
in 15.03 % cases, no bacteria could be seen.
Sputum culture revealed 53.8% streptococcus pneumoniae,
26.9% Klebsiella pneumonia as predominant organism.
Mycoplasma pneumoniae and Chlamydia pneumoniae were
found in 7.4% and 3.7% respectively by serological test. For
Streptococcus pneumoniae, sensitive antibiotics were
Amoxyclav and Levofloxacin. For Gram negative bacilli
and coccobacilli, more sensitive antibiotics were Meropenem,
Ceftriaxone, and Clarithromycin. The best sensitive drug
were found meropenem. The mean (±SD) duration of hospital
stay was 5.0±1.7 days with ranging from 3 to 10 days.
Conclusion: Region based bacteroiological diagnosis of Cap
is important for selecting the best and sensitive drugs for
complete cure.
(J Bangladesh Coll Phys Surg 2016; 34: 128-134)