study on the aetiology of pneumonia in Cairo and Tanta university hospitals, a bacteriologic approach

ABSTRACT

One hundred and sixty [160] cases of "pneumonia" with proved clinical and radiologic evidence from the Chest Departments in Cairo and Tanta University Hospitals during the year 2007, were the subjects of a conventional bacteriologic study having in mind the empirical approach in the antibiotic therapy. They represented 4.06% of the yearly admissions. The major age incidence was 16 year with more male sex predilection. 92.5% belonged to CAP [community acquired pneumonia] and only 7.5% to HAP [hospital acquired pneumonia], VAP [ventilator associated pneumonia] being excluded. 80.6% were primary; with no antedating pathology in the patients, while 19.4% were secondary with comorbidity in such patients; out which malignancy and COPD were the main associations in older age groups and foreign body in younger ages. The causative organisms were bacteriologically identified only in 53.7% of cases. The main organism in the causation of CAP was Streptococcus pneumoniae in 51.7% of the cases, followed by Hemophylus influenzae in 15.5%, while in HAP, 2 major organisms were responsible for the disease; namely Streptococcus pneumoniae and Klebsiella pneumonia; 33.3% for each, followed by Hemophylus influenza and Streptococcus pyogenes; 11.1% for each, but the number of cases in HAP is too small to draw valid conclusions. The organism detected, in primary pneumonia was also essentially Streptococcus pneumoniae 57.6%, while in secondary pneumonia the same organism was encountered in only 33.3% of the cases. Concerning the lobar and lobular distribution of the disease the S. pneumoniae was overwhelming in the lobar type 84.2%, while in the lobular Bronchopneumonic type the main organisms, besides S. pneumoniae which was responsible for 22.2% of the cases, were Streptococcus pyogenes was responsible for one quarter of the cases and H. influenza which was encountered in 22.2%. Figures for other organisms are detailed in the text with their relation to other parameters of the study