Epidemiological profile of severe community-acquired pneumonia in an intensive care unit

Abstract

Background: Community-acquired pneumonia is an important and common cause of morbidity and mortality. There are no epidemiological profiles of the population hospitalized in Costa Rica due to this cause. The aim of this study was to identify the demographic, clinical and microbiological profile of patients admitted to the intensive care unit during thirteen months.Method: A database which included the main clinical and laboratory variables of patients admitted with a diagnosis of severe community acquired pneumonia was created. In order to obtain microbiological identification blood cultures, bronchial aspirate and real-time polymerase chain reaction analysis were performed.Results: Twenty eight patients were recruited. The infectious agent was identified in 90% of the cases. Ages ranged from 18 to 65 years old. In 53% of cases a comorbidity was identified, the most common ones were high blood pressure, diabetes mellitus, chronic lung disease, immunosuppression, chronic kidney disease and obesity. Pneumococcus was the most frequently identified germ, found in 53.5% of cases, followed by respiratory viruses in 18.9% and Haemophilus influenza in 7.1% of cases. The most commonly used antibiotics were third-generation cephalosporines, macrolides and fluoroquinolones. Mortality was 21%.Conclusion: The most frequent etiologic agent was Pneumococcus sp. and the empiric antibiotic therapy was consistent with this finding. Respiratory virus area major cause of community-acquired pneumonia. Atypical microorganisms were not isolated and Staphylococcus sp was always identified in combination with other germs.