Etiology and Prognostic Factors of Community-Acquired Pneumonia

INTRODUCTION: Community acquired pneumonia (CAP) is an important health problem because of its high prevalence and mortality. In empirical treatment decision, clinical data have critical importance. In this study, we aimed to determine the etiological factors and prognostic markers in the patients who have CAP.
METHODS: The present study was conducted with 65 patients with CAP, who were referred November 2011 and November 2012. For etiologic evolution, sputum, bronchial lavage, direct microscopic examination, and cultures of blood samples and bronchial lavage were performed. For prognostic evolution, complete blood count, C-reactive protein, sedimentation, and biochemical parameters were evaluated. The patients were classified according to ATS, PSI, and CURB-65 critera and their associations with prognosis were analyzed.
RESULTS: According to the Turkish Thorax Society 2009 CAP Guideline, there were 44 patients (67.7%) in Group 1, 15 (23.1%) in Group 2, and 6 (9.2%) in Group 3. The most common used antibiotics were new generation quinolones, third generation cephalosporins, and macrolid combinations. The most common lung involvement was lober. In sputum culture and direct microscobic examination, the most common etiologic agent was coagulase negative staphilococci and there was no resistance to those antibiotics. The duration of treatment was ranged between 15 days.
DISCUSSION AND CONCLUSION: In the etiologic investigation, any agent was isolated in approximately 30% of patients. For this reason, empirical antibiotic therapy is important in prognosis. It should be started without delay in the presence of guidelines and considering the patient’s clinical findings and previous antibiotic use. Prospective studies involving large numbers of patients are needed to investigate regional data.