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Abstract：
BACKGROUND: Community-acquired pneumonia (CAP) is an acute lung infection affecting the alveoli in individuals who have not had recent exposure to healthcare settings. It is characterized by newly detected pulmonary infiltration on a chest X-ray or computed tomography scan, accompanied by at least two of the following symptoms: a new or worsening cough, shortness of breath, increased sputum production, fever or hypothermia, pleuritic chest pain, hypoxia, confusion, or an abnormal WBC count (either leukopenia or leukocytosis). It is a major contributor to global mortality and morbidity, especially in elderly populations. This study aims to investigate the etiology of CAP in our region and analyze the clinical characteristics of patients diagnosed with CAP.
METHODS: This prospective, hospital-based study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, a 2,011-bed multispecialty hospital. The study included 100 patients over 18 years old, diagnosed with CAP, and hospitalized between January 2023 and January 2024. All patients underwent a thorough clinical assessment, and sputum cultures were collected on the day of admission. Patients under 18 years old, those who had been hospitalized within the preceding two weeks, individuals with pneumonia caused by tuberculosis or aspiration pneumonia, patients with compromised immune systems, and pregnant women were excluded.
RESULTS: The study included 100 patients with a mean age of 53.13 years (±18.31). The most common age group was 59-68 years, which included 25 (25%) cases, followed by the 69-78 year age group with 18 (18%) cases and the 18-28 year age group with 15 (15%) cases. The majority were male, with 61 (61%) cases. Common symptoms included fever in 78 cases (78%), chest pain in 69 cases (69%), dyspnea in 65 cases (65%), and cough in 51 cases (51%). Sputum cultures showed growth in 65 cases (65%), with Klebsiella pneumoniae being the most prevalent pathogen in 28 cases (43%), followed by Streptococcus pneumoniae in 18 cases (28%). Together, these two pathogens accounted for 46 out of 65 positive samples (70%).
CONCLUSIONS: This study highlights the clinical profile and rising etiology of K. pneumoniae in CAP in adults in Western India, particularly in the elderly. These findings underscore the need for periodic updates on CAP etiology to inform empirical treatment strategies effectively. Future research should use advanced diagnostics and diverse samples to refine CAP management, with continuous monitoring to update treatment protocols.
METHODS: This prospective, hospital-based study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, a 2,011-bed multispecialty hospital. The study included 100 patients over 18 years old, diagnosed with CAP, and hospitalized between January 2023 and January 2024. All patients underwent a thorough clinical assessment, and sputum cultures were collected on the day of admission. Patients under 18 years old, those who had been hospitalized within the preceding two weeks, individuals with pneumonia caused by tuberculosis or aspiration pneumonia, patients with compromised immune systems, and pregnant women were excluded.
RESULTS: The study included 100 patients with a mean age of 53.13 years (±18.31). The most common age group was 59-68 years, which included 25 (25%) cases, followed by the 69-78 year age group with 18 (18%) cases and the 18-28 year age group with 15 (15%) cases. The majority were male, with 61 (61%) cases. Common symptoms included fever in 78 cases (78%), chest pain in 69 cases (69%), dyspnea in 65 cases (65%), and cough in 51 cases (51%). Sputum cultures showed growth in 65 cases (65%), with Klebsiella pneumoniae being the most prevalent pathogen in 28 cases (43%), followed by Streptococcus pneumoniae in 18 cases (28%). Together, these two pathogens accounted for 46 out of 65 positive samples (70%).
CONCLUSIONS: This study highlights the clinical profile and rising etiology of K. pneumoniae in CAP in adults in Western India, particularly in the elderly. These findings underscore the need for periodic updates on CAP etiology to inform empirical treatment strategies effectively. Future research should use advanced diagnostics and diverse samples to refine CAP management, with continuous monitoring to update treatment protocols.
摘要：
背景：社区获得性肺炎（CAP）是一种急性肺部感染，影响近期未接触过医疗机构的个体的肺泡。它的特征是在胸部X射线或计算机断层扫描扫描上新发现的肺浸润，伴有以下至少两种症状：新的或恶化的咳嗽，呼吸急促,痰液产量增加，发烧或体温过低，胸膜炎性胸痛，缺氧,混乱,或白细胞计数异常（白细胞减少或白细胞增多）。它是全球死亡率和发病率的主要贡献者，尤其是老年人群。本研究旨在探讨本地区CAP的病因,分析确诊为CAP患者的临床特点。
方法：这种前瞻性，基于医院的研究是在D.Y.Patil医学院进行的，医院和研究中心，浦那,一家拥有2,011张病床的多专科医院。该研究包括100名18岁以上的患者，诊断为CAP,并在2023年1月至2024年1月期间住院。所有患者都接受了全面的临床评估，入院当天收集痰培养物。18岁以下的患者，那些在前两周内住院的人，由肺结核或吸入性肺炎引起的肺炎患者，免疫系统受损的患者，孕妇被排除在外。
结果：该研究包括100名患者，平均年龄53.13岁(±18.31)。最常见的年龄组是59-68岁，其中包括25例(25%)，其次是69-78岁年龄组18例(18%)和18-28岁年龄组15例(15%).大多数是男性，61例（61%）。常见症状包括发热78例（78%），胸痛69例（69%），呼吸困难65例（65%），咳嗽51例(51%)。65例（65%）痰培养显示生长，肺炎克雷伯菌是28例(43%)中最常见的病原体，其次是肺炎链球菌18例(28%)。一起,这两种病原体占65份阳性样本中的46份(70%)。
结论：这项研究强调了印度西部成人CAP中肺炎克雷伯菌的临床特征和病因学上升，尤其是老年人。这些发现强调了定期更新CAP病因的必要性，以有效地为经验治疗策略提供信息。未来的研究应该使用先进的诊断和不同的样本来完善CAP管理，持续监测以更新治疗方案。
方法：这种前瞻性，基于医院的研究是在D.Y.Patil医学院进行的，医院和研究中心，浦那,一家拥有2,011张病床的多专科医院。该研究包括100名18岁以上的患者，诊断为CAP,并在2023年1月至2024年1月期间住院。所有患者都接受了全面的临床评估，入院当天收集痰培养物。18岁以下的患者，那些在前两周内住院的人，由肺结核或吸入性肺炎引起的肺炎患者，免疫系统受损的患者，孕妇被排除在外。
结果：该研究包括100名患者，平均年龄53.13岁(±18.31)。最常见的年龄组是59-68岁，其中包括25例(25%)，其次是69-78岁年龄组18例(18%)和18-28岁年龄组15例(15%).大多数是男性，61例（61%）。常见症状包括发热78例（78%），胸痛69例（69%），呼吸困难65例（65%），咳嗽51例(51%)。65例（65%）痰培养显示生长，肺炎克雷伯菌是28例(43%)中最常见的病原体，其次是肺炎链球菌18例(28%)。一起,这两种病原体占65份阳性样本中的46份(70%)。
结论：这项研究强调了印度西部成人CAP中肺炎克雷伯菌的临床特征和病因学上升，尤其是老年人。这些发现强调了定期更新CAP病因的必要性，以有效地为经验治疗策略提供信息。未来的研究应该使用先进的诊断和不同的样本来完善CAP管理，持续监测以更新治疗方案。
