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Microbial variations in sputum cultures among hospitalized patients with community-acquired pneumonia: differences in
Fatih Uzer1, Burcu Karaboğa2, A Gamze Çalış3
1. Department of Chest Disease, Akdeniz University School of Medicine, Antalya, Turkey.
Objective:
To assess differences in the sputum microbiota of community-acquired pneumonia (CAP) patients with either COPD or asthma, specifically focusing on a patient population in Turkey.
Methods:
This retrospective study included hospitalized patients > 18 years of age with a diagnosis of pneumonia between January of 2021 and January of 2023. Participants were recruited from two hospitals, and three patient groups were considered: CAP patients with asthma, CAP patients with COPD, and CAP patients without COPD or asthma.
Results:
A total of 246 patients with CAP were included in the study, 184 (74.8%) and 62 (25.2%) being males and females, with a mean age of 66 ± 14 years. Among the participants, 52.9% had COPD, 14.2% had asthma, and 32.9% had CAP but no COPD or asthma. Upon analysis of sputum cultures, positive sputum culture growth was observed in 52.9% of patients. The most commonly isolated microorganisms were Pseudomonas aeruginosa (n = 40), Acinetobacter baumannii (n = 20), Klebsiella pneumoniae (n = 16), and Moraxella catarrhalis (n = 8). CAP patients with COPD were more likely to have a positive sputum culture (p = 0.038), a history of antibiotic use within the past three months (p = 0.03), utilization of long-term home oxygen therapy (p < 0.001), and use of noninvasive ventilation (p = 0.001) when compared with the other patient groups. Additionally, CAP patients with COPD had a higher CURB-65 score when compared with CAP patients with asthma (p = 0.004).
Conclusions:
This study demonstrates that CAP patients with COPD tend to have more severe presentations, while CAP patients with asthma show varied microbial profiles, underscoring the need for patient-specific management strategies in CAP.
Insights
Community-acquired pneumonia (CAP) patients with chronic obstructive pulmonary disease (COPD) often present with more severe symptoms and distinct microbial profiles compared to those with asthma. Tailored management strategies are crucial for effective CAP treatment.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Microbiology
Background:
- Community-acquired pneumonia (CAP) management can be complicated by comorbidities like chronic obstructive pulmonary disease (COPD) and asthma.
- Understanding the sputum microbiota differences in CAP patients with these conditions is vital for targeted therapies.
Purpose of the Study:
- To investigate and compare the sputum microbiota in community-acquired pneumonia (CAP) patients with COPD versus asthma in a Turkish population.
- To identify clinical and microbiological differences between these patient groups.
Main Methods:
- A retrospective study involving 246 hospitalized CAP patients (aged >18) between January 2021 and January 2023.
- Patients were categorized into three groups: CAP with asthma, CAP with COPD, and CAP without either comorbidity.
- Sputum cultures were analyzed, and clinical data including CURB-65 scores were collected.
Main Results:
- Over half of CAP patients (52.9%) had COPD, while 14.2% had asthma.
- Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were common pathogens.
- CAP patients with COPD showed higher rates of positive sputum cultures, prior antibiotic use, home oxygen therapy, and noninvasive ventilation use, along with higher CURB-65 scores compared to asthma patients.
Conclusions:
- CAP patients with COPD exhibit more severe clinical presentations and distinct microbiological findings.
- CAP patients with asthma present with varied microbial profiles.
- Individualized management approaches are essential for CAP patients, considering their specific comorbidities.
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