Neumonía adquirida en la comunidad que se hospitaliza: estudio etiológico / Community acquired pneumonia in a hospitalized community: etiological study

ABSTRACT

BACKGROUND: Community-acquired pneumonia (CAP) that requires hospitalization, is a common and serious disease. A permanent assessment in specialized centers, to define therapeutic guidelines according to local epidemiological factors, is mandatory. AIM: To study the etiology of CAP requiring hospital admission. PATIENTS AND METHODS: Adult patients with CAP, admitted to the Clinical Hospital of the University of Chile between 1999 and 2001 were studied. A clinical, radiological and microbiological assessment was done in all patients. Blood and sputum cultures and serology for Chlamydia and Mycoplasma pneumoniae were performed. RESULTS: Thirty one patients aged 62 +/- 18 years, 12 female, met inclusion criteria. An etiologic diagnosis was made in 74 per cent of cases, (52 per cent definitive, 22 per cent probable). Frequency of definitive diagnosis was 25 per cent Mycoplasma pneumoniae, 19 per cent Chlamydia pneumoniae and 13 per cent Streptococcus pneumoniae. Mixed etiology was found in 16 per cent and a final diagnosis was not obtained in 26 per cent of the cases. No correlation was found between clinical and radiological patterns, and the etiologic agent. C reactive protein and erythrosedimentation rate were significantly higher in CAP due to Chlamydia and Streptococcus pneumoniae. CONCLUSIONS: The higher frequency of Mycoplasma and Chlamydia pneumoniae, than previously reported, suggests that atypical agents should be considered in the initial antimicrobial therapy prescribed to these patients.