Vikhe Vikram B, Faruqi Ahsan A, Patil Rahul S, Reddy Avani, Khandol Devansh
General Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Pune, IND.
Cureus. 2024 Jul 6;16(7):e63976. doi: 10.7759/cureus.63976. eCollection 2024 Jul.
This systematic review aimed to consolidate findings on the etiology of community-acquired pneumonia (CAP) among Indian adults. We adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Guidelines 2020 and conducted a comprehensive search across databases including PubMed, Scopus-Elsevier, and hand-searched reference lists using key terms such as "Community-Acquired Pneumonia," "CAP," "Indian," and "adults." Articles published between January 2010 and January 2024 were included, with exclusions for studies involving pediatric populations, non-Indian patients, or those published before 2010. From an initial pool of 344 articles, duplicates were removed and titles and abstracts were screened, resulting in nine studies meeting the inclusion criteria. The analysis of pooled data comprising 1,643 Indian adult participants revealed the following pathogen distribution: was the most common organism, accounting for 33% of the cases. This was followed by at 23%, at 10%, and each at 7%, and , , and each at 4%. Notably, the review highlights a rising incidence of in CAP cases, which is a significant concern and should be considered when treating CAP patients in India. The findings emphasize the importance of comprehensive diagnostic testing, including advanced methods such as bronchoalveolar lavage, urinary antigen tests, serology for atypical pathogens, and enzyme-linked immunosorbent assays, to improve diagnostic yield and guide targeted antibiotic therapy. This review underscores the need for updated empirical treatment guidelines that account for dominant pathogens. Future research should focus on employing advanced diagnostic methods to enhance understanding of CAP etiology.
本系统评价旨在汇总印度成年人社区获得性肺炎（CAP）病因的研究结果。我们遵循《系统评价和Meta分析的首选报告项目》（PRISMA）2020指南，对包括PubMed、Scopus-爱思唯尔在内的数据库进行了全面检索，并对手检的参考文献列表使用了“社区获得性肺炎”、“CAP”、“印度”和“成年人”等关键词。纳入了2010年1月至2024年1月发表的文章，排除了涉及儿科人群、非印度患者或2010年之前发表的研究。从最初的344篇文章中，去除了重复项并筛选了标题和摘要，最终有9项研究符合纳入标准。对包含1643名印度成年参与者的汇总数据进行分析后发现病原体分布如下： 是最常见的病原体，占病例的33%。其次是 ，占23%， 占10%， 、 和 各占7%， 、 和 各占4%。值得注意的是，该评价强调了CAP病例中 发病率的上升，这是一个重大问题，在印度治疗CAP患者时应予以考虑。研究结果强调了全面诊断检测的重要性，包括支气管肺泡灌洗、尿抗原检测、非典型病原体血清学检测和酶联免疫吸附测定等先进方法，以提高诊断率并指导针对性抗生素治疗。本评价强调了制定考虑主要病原体的更新经验性治疗指南的必要性。未来的研究应侧重于采用先进的诊断方法，以增强对CAP病因的理解。
