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[Community acquired pneumonia in a hospitalized community: etiological study]
Mauricio Fernández1, Mónica Zagolin, Mauricio Ruiz
1Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santos Dumont 999, Santiago, Chile. mauriciof@entelchile.net
Background:
Community-acquired pneumonia (CAP) that requires hospitalization, is a common and serious disease. A permanent assessment in specialized centers, to define therapeutic guidelines according to local epidemiological factors, is mandatory.
Aim:
To study the etiology of CAP requiring hospital admission.
Patients And Methods:
Adult patients with CAP, admitted to the Clinical Hospital of the University of Chile between 1999 and 2001 were studied. A clinical, radiological and microbiological assessment was done in all patients. Blood and sputum cultures and serology for Chlamydia and Mycoplasma pneumoniae were performed.
Results:
Thirty one patients aged 62 +/- 18 years, 12 female, met inclusion criteria. An etiologic diagnosis was made in 74% of cases, (52% definitive, 22% probable). Frequency of definitive diagnosis was: 25% Mycoplasma pneumoniae, 19% Chlamydia pneumoniae and 13% Streptococcus pneumoniae. Mixed etiology was found in 16% and a final diagnosis was not obtained in 26% of the cases. No correlation was found between clinical and radiological patterns, and the etiologic agent. C reactive protein and erythrosedimentation rate were significantly higher in CAP due to Chlamydia and Streptococcus pneumoniae.
Conclusions:
The higher frequency of Mycoplasma and Chlamydia pneumoniae, than previously reported, suggests that atypical agents should be considered in the initial antimicrobial therapy prescribed to these patients.