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VOLUME 11 , ISSUE 2 ( April-June, 2022 ) > List of Articles

Original Article

Clinico - Bacteriological Profile of Community-acquired Pneumonia Patients at Tertiary Care Center of North India

Prashant Yadav, Ashish Kumar Gupta, Aditya Kumar Gautam, Adesh Kumar, Shivam Priyadarshi, Dhiraj Kumar Srivastav

Keywords : 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.

DOI: 10.4103/ijrc.ijrc_145_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


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.

  1. US Department of Commerce; Bureau of Census. Statistical Abstract of United States. 104th ed. Washington DC: USGPO; 1984.
  2. Mahashur A, Rodrigues C, Dumra H, Ghoshal AG, Samaria JK, Soman R, et al. Special issue on epidemiology of community - Acquired pneumonia. JAPI 2013;61:7-8.
  3. Ghoshal AG. Burden of pneumonia in the community. JAPI
  4. Torres A, Serra-Batlles J, Ferrer A, Jimenez P, Cellis R, Cobo E, et al. Severe community acquired pneumonia; epidemiology and prognostic factors. Am Rev Respir Dis 1991;144:312-8.
  5. Panchon J, Pardos MD, Capote F, Cuella JA, Garnacho J, Veerano A. Severe community acquired pneumonia: Etiology, prognosis and treatment. Am Rev Respir Dis 1990;142:369-73.
  6. Colice GL, Morley MA, Asche C, Birnbaum HG. Treatment costs of community-acquired pneumonia in an employed population. Chest
  7. Nair GB, Niederman MS. Community-acquired pneumonia: An unfinished battle. Med Clin North Am 2011;95:1143-61.
  8. Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, et al. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med
  9. Lode HM. Managing community-acquired pneumonia: A European perspective. Respir Med 2007;101:1864-73.
  10. Capoor MR, Nair D, Aggarwal P, Gupta B. Rapid diagnosis of community acquired pneumonia using the Bac T/alert 3 D system. Braz J Infect Dis 2006;10:352-6.
  11. Bansal S, Kashyap S, Pal LS, Goel A. Clinical and bacteriological profile of community acquired pneumonia in Shimla, Himachal Pradesh. Indian J Chest Dis Allied Sci 2004;46:17-22.
  12. Oberoi A, Agarwal A. Bacteriological profile, serology and antibiotic sensitivity pattern of microorganisms from community acquired pneumonia. JK Sci 2006;8:79-82.
  13. Lee KH, Hui KP, Tan WC, Lim TK. Severe community-acquired pneumonia in Singapore. Singapore Med J 1996;37:374-7.
  14. Lim WS, Baudouin SV, George RC, Hill AT, Jamieson C, Le Jeune I, et al. BTS guidelines for the management of community acquired pneumonia in adults: Update 2009. Thorax 2009;64 Suppl 3:i1-55.
  15. Hudzicki J. Kirby-Bauer Disk Diffusion Susceptibility Test Protocol. Washington, DC, USA: Microbe Library. American Society for Microbiology ©; 2016.
  16. Hajian-Tilaki K. Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J Intern Med
  17. Blasi F, Mantero M, Santus P, Tarsia P. Understanding the burden of pneumococcal disease in adults. Clin Microbiol Infect
  18. Shah BA, Singh G, Naik MA, Dhobi GN. Bacteriological and clinical profile of Community acquired pneumonia in hospitalized patients. Lung India 2010;27:54-7.
  19. Morimoto K, Suzuki M, Ishifuji T, Yaegashi M, Asoh N, Hamashige N, et al. The burden and etiology of community-onset pneumonia in the aging Japanese population: A multicenter prospective study. PLoS One
  20. Montull B, Menéndez R, Torres A, Reyes S, Méndez R, Zalacaín R, et al. Predictors of severe sepsis among patients hospitalized for community-acquired pneumonia. PLoS One 2016;11:e0145929.
  21. Cataudella E, Giraffa CM, Di Marca S, Pulvirenti A, Alaimo S, Pisano M, et al. Neutrophil-to-lymphocyte ratio: An emerging marker predicting prognosis in elderly adults with community-acquired pneumonia. J Am Geriatr Soc 2017;65:1796-801.
  22. Ge YL, Zhang HF, Zhang Q, Zhu XY, Liu CH, Wang N, et al. Neutrophil-to-lymphocyte ratio in adult community-acquired pneumonia patients correlates with unfavorable clinical outcomes. Clin Lab 2019;65. [].
  23. Acharya VK, Padyana M, Unnikrishnan B, Anand R, Acharya PR, Juneja DJ. Microbiological profile and drug sensitivity pattern among community acquired pneumonia patients in tertiary care centre in Mangalore, Coastal Karnataka, India. J Clin Diagn Res 2014;8:C04-6.
  24. Jain SK, Jain S, Trikha S. Study of clinical, radiological, and bacteriological profile of community-acquired pneumonia in hospitalized patients of Gajra Raja Medical College, Gwalior, Central India. Int J Sci Study 2014;2:96-100.
  25. Chintaman AC, Ghadage DP, Bhore AV. Bacteriological profile of community acquired pneumonia in a tertiary care hospital. Int J Curr Microbiol Appl Sci 2017;6:190-4.
  26. Ibrahim AI, Hassan AA, Ahmed OA, Daffalla SO. Bacterial etiology of community acquired pneumonia and their antimicrobial susceptibility in patients admitted to Alshaab teaching hospital, Sudan. Asian J Biomed Pharm Sci 2019;9:1-6.
  27. Para RA, Fomda BA, Jan RA, Shah S, Koul PA. Microbial etiology in hospitalized North Indian adults with community-acquired pneumonia. Lung India 2018;35:108-15.
  28. Liam CK, Pang YK, Poosparajah S. Pulmonary tuberculosis presenting as community-acquired pneumonia. Respirology 2006;11:786-92.
  29. Akter S, Shamsuzzaman SM, Jahan F. Community acquired bacterial pneumonia: Aetiology, laboratory detection and antibiotic susceptibility pattern. Malays J Pathol 2014;36:97-103.
  30. Storms AD, Chen J, Jackson LA, Nordin JD, Naleway AL, Glanz JM, et al. Rates and risk factors associated with hospitalization for pneumonia with ICU admission among adults. BMC Pulm Med 2017;17:208.
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