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Etiology of community-acquired pneumonia in patients requiring hospitalization
Abstract:
The etiology of community-acquired pneumonia was studied in 127 patients with roentgenologically verified pneumonia who needed hospitalization. Etiology was determined on the basis of a positive blood culture and/or a significant antibody titer increase. Streptococcus pneumoniae was the probable etiological agent in 69 patients, nontypeable Haemophilus influenzae in five patients, Streptococcus pyogenes in two patients, and Legionella pneumophila and Staphylococcus aureus in one patient each. Evidence of Mycoplasma pneumoniae infection was found in 18 patients and of Chlamydia psittaci infection in three patients. Influenza virus type A was the cause of infection in 15 patients. One patient had infection with influenza virus type B, one patient with parainfluenza virus type 1, and three patients with respiratory syncytial virus. In 20 patients there was evidence of infection with more than one microorganism. No etiological agent was found in 27 patients. Since Streptococcus pneumoniae was the predominant etiological agent penicillin should be drug of first choice in patients with pneumonia who need treatment in hospital. In young adults, however, the high frequency of Mycoplasma pneumoniae infection would justify the use of erythromycin or doxycycline as drug of first choice.
Insights
Streptococcus pneumoniae is the primary cause of community-acquired pneumonia requiring hospitalization. Penicillin is recommended, but erythromycin or doxycycline may be better for young adults due to Mycoplasma pneumoniae.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality.
- Accurate etiological diagnosis is crucial for effective treatment of CAP.
- Hospitalized patients often present complex etiological profiles.
Purpose of the Study:
- To determine the etiological agents responsible for community-acquired pneumonia in hospitalized patients.
- To identify the most common pathogens causing CAP in this cohort.
- To inform antibiotic treatment guidelines for CAP.
Main Methods:
- Retrospective analysis of 127 hospitalized patients with radiologically confirmed pneumonia.
- Etiological diagnosis based on positive blood cultures and/or significant increases in antibody titers.
- Identification of bacterial, atypical, and viral pathogens.
Main Results:
- Streptococcus pneumoniae was identified as the most frequent cause (69 patients).
- Mycoplasma pneumoniae (18 patients) and Influenza A virus (15 patients) were also significant causes.
- Coinfections with multiple microorganisms were observed in 20 patients; no agent was found in 27.
Conclusions:
- Streptococcus pneumoniae is the predominant pathogen in hospitalized CAP, supporting penicillin as a first-line treatment.
- In young adults, Mycoplasma pneumoniae is prevalent, suggesting erythromycin or doxycycline as alternative first-line agents.
- Comprehensive etiological investigation is essential for optimizing CAP management.