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印度西部成人社区获得性肺炎的病因及临床表现研究

A Study on the Etiology and Clinical Manifestations of Community-Acquired Pneumonia in Adults in Western India.

作者信息

Vikhe Vikram B, Faruqi Ahsan A, Patil Rahul S, Patel Harshad, Khandol Devansh, Reddy Avani

机构信息

General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Jun 25;16(6):e63132. doi: 10.7759/cureus.63132. eCollection 2024 Jun.

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.

METHODOLOGY

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 being the most prevalent pathogen in 28 cases (43%), followed by 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 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。其特征是胸部X线或计算机断层扫描显示新发现的肺部浸润,并伴有以下至少两种症状:新发或加重的咳嗽、呼吸急促、痰液产生增加、发热或体温过低、胸膜炎性胸痛、缺氧、意识模糊或白细胞计数异常(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促成因素,尤其是在老年人群中。本研究旨在调查我们地区CAP的病因,并分析诊断为CAP的患者的临床特征。

方法

这项前瞻性的基于医院的研究在浦那的D.Y.帕蒂尔医学院、医院和研究中心进行,这是一家拥有2011张床位的多专科医院。该研究纳入了100名18岁以上诊断为CAP并于2023年1月至2024年1月住院的患者。所有患者均接受了全面的临床评估,并在入院当天采集了痰培养样本。排除18岁以下患者、前两周内住院的患者、由结核病或吸入性肺炎引起的肺炎患者、免疫系统受损患者和孕妇。

结果

该研究纳入了100名患者,平均年龄为53.13岁(±18.31)。最常见的年龄组是59 - 68岁,有25例(25%),其次是69 - 78岁年龄组,有18例(18%),18 - 28岁年龄组有15例(15%)。大多数为男性,有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%)和咳嗽51例(51%)。痰培养有65例(65%)生长,其中[具体病原体1]在28例(43%)中最为常见,其次是[具体病原体2]在18例(28%)中。这两种病原体在65份阳性样本中共占46份(70%)。

结论

本研究突出了印度西部成人CAP的临床概况和不断上升的病因,特别是在老年人中。这些发现强调了定期更新CAP病因以有效指导经验性治疗策略的必要性。未来的研究应使用先进的诊断方法和多样的样本以优化CAP管理,并持续监测以更新治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5ad/11272150/030b91c2b371/cureus-0016-00000063132-i01.jpg

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