Absolute neutrophil count, community-acquired pneumonia, CRB-65, neutrophil-to-lymphocyte ratio ratio
Citation Information :
Yadav P, Gupta AK, Gautam AK, Kumar A, Priyadarshi S, Srivastav DK. Clinico - Bacteriological Profile of Community-acquired Pneumonia Patients at Tertiary Care Center of North India. Indian J Respir Care 2022; 11 (2):117-123.
Background: Pneumonia is an acute inflammation of the pulmonary parenchyma, and its etiology can be the infective or noninfective origin. It is the sixth-leading cause of death from infectious disease in the United States, yet Indian epidemiological data were lacking on this subject.
Materials and Methods: A hospital-based prospective observational study was done from January 2019 to June 2020. One hundred and twenty-five patients with community-acquired pneumonia (CAP) who met the inclusion and exclusion criteria during the study period were included in this study. In all patients, routine investigations and three sputum samples and two blood samples from two different sites for culture were taken on the 1st day of admission before starting the antibiotics.
Results: Out of the 125 study participants, 80 (64%) were male, and 45 (36%) were female. The mean age of the study participants was 50.5 ± 17.2 years. Cough (99%) was the most common symptom. Chronic obstructive pulmonary disease (COPD) (25.6%) and asthma (25.6%) were the most common comorbidities. Absolute neutrophil count is the single best predictor of mortality in admitted patients of CAP (area under the curve [AUC] of 0.975) followed by total leukocyte count (AUC = 0.963) and neutrophil lymphocyte ratio (AUC = 0.925) and CRB-65 = Confusion, Respiratory rate, Blood pressure, 65 years of age and older (CRB 65 score) (AUC = 0.922) in predicting mortality in CAP. Overall bacterial growth was seen in 91 (72.8%) cases, among 74 (59.20%) Gram-negative and 17 (13.6%) were Gram-positive.
Conclusion: Klebsiella pneumoniae was the most common bacteria isolated from all samples. Most of the isolates in our study were resistant to cotrimoxazole and ertapaenem, and these antibiotics should not be given as empirical antibiotics in patients of CAP.
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