Severe community-acquired pneumonia (CAP) treated at Srinagarind Hospital, Khon Kaen, Thailand.
Southeast Asian J Trop Med Public Health
;
2004 Jun; 35(2): 430-3
Artigo
em Inglês
| IMSEAR
| ID: sea-31444
ABSTRACT
In Thailand, the death rate from community-acquired pneumonia (CAP), especially severe CAP, has increased steadily over the past decade. To optimize the outcome, rapid start of appropriate antibiotics and supportive care are the mainstay of management. We therefore assessed the local etiology and outcome of adult patients with severe CAP admitted between January 1, 1999 and December 31, 2001. One hundred and five of 383 patients (27.4%) met the ATS criteria for severe CAP. The mean age was 56.9 (SD 18.2) years. The male to female ratio was 6045. Duration of symptoms before admission was 5.3 (SD 4.0) days. Most of them (91.4%) had co-morbidity, diabetes mellitus being most common. A microbiological pathogen was isolated in 62 patients (59%). The pathogens most commonly isolated were B. pseudomallei (29.4%), S. pneumoniae (20.6%), K. pneumoniae (19.1%), and H. influenzae (11.8%). Other less common pathogens were E. coli (5.9%), S. aureus (5.9%), M. pneumoniae (1.5%), M. catarrhalis (1.5%), P. aeruginosa (1.5%), P. fluorescens (1.5%), and S. stercoralis (1.5%). Hospitalization averaged 14.7 (SD 14.3) days and mortality was 21%. Clinicals in 17.1 % of patients did not improve and they transferred home. Most (81.9%) patients required mechanical ventilation, while 60 (57.1%) developed septic shock, and 13 (12.3%) acute renal failure. Severe CAP carried high mortality, despite intensive care. Empirical therapy for B. pseudomallei should be considered, where endemic, and for patients with diabetes mellitus or chronic renal failure.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Tailândia
/
Feminino
/
Humanos
/
Masculino
/
Ceftazidima
/
Estudos Transversais
/
Resultado do Tratamento
/
Infecções Comunitárias Adquiridas
/
Pneumonia Bacteriana
/
Hospitais de Ensino
Tipo de estudo:
Estudo observacional
/
Estudo de prevalência
/
Fatores de risco
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Southeast Asian J Trop Med Public Health
Ano de publicação:
2004
Tipo de documento:
Artigo
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