Etiology of community-acquired pneumonia: Case series at the Hospital of San José

Etiología de la neumonía adquirida en la comunidad: Serie de casos del Hospital de San José

Community-acquired pneumonia (CAP) continues to be a serious disease. More than 5.6 million cases occur annually and about 1.1 million require hospitalization. In the Hospital of San José, during the last two years, a high percentage of NAC was found as a cause of admission to the internal medicine service (37.5%). Given the implications of the presence of this disease, it is important to know the causative germs and the sensitivity to the different antibiotics used. We conducted a descriptive study of a series of 159 patients admitted with a diagnosis of CAP, from April 1, 2003 to November 30, 2005. Of these, 63 men (49.62%) and 96 women (60.37%). 86 were classified as NAC IIIA (54.1%), 66 as NAC IIIB (41.5%), 6 NAC VAT (3.8%) and one patient as NAC IVB (0.6%). The casual germ was isolated in 8.8% of the samples taken, the most frequent being Klebsiella pneumoniae (3.1%), followed in a lesser percentage by Streptococcus pneumoniae, Staphylococcus aureus, Staphylococcus hominis and Pseudomona aeruginosa. Abbreviations: NAC, pneumonia acquired in the community; NAC I, II, III A, III B, IV A, IV B, see Table 2; COPD, chronic obstructive pulmonary disease, DM, diabetes mellitus, CRF, chronic renal failure; ICC, congestive heart failure.

1. Pierre Y. Community-acquired pneumonia. Clin Infect Dis. 2001;80:75-87.

2. American Thoracic Society. Guidelines for the management of Adults with Community-acquired Pneumonia. Crit Care Med. 2001;163:1730-1754.

3. Levinson ME. Neumonía, comprendidas las infecciones pulmonares necrotizantes. En: Braunwald E, Fauci AS, Kasper D, Hauser S, Longo D, Jameson J., editores. Harrison Principios de Medicina Interna. 15 ed. 2002:1729-1740.

4. Chaparro C. Manejo de las nemonías de los adultos. En: Camacho F, Awad, C, editores. Enfermedades del Tórax. [Bogotá]: Hospital Santa Clara; [1992] p. 226-243.

5. Caballero A. Infecciones del aparato respiratorio. En: Chalem F, Escandón J, Campos J, Esguerra R. Medicina interna. 3a. ed. 1998. p. 1457-1462.

6. Barlett. J. Practice Guidelines for the management of Community-Acquired Pneumonia in adults. Clin Infect Dis. 2000 Sep; 31: 347-82.

7. Niederman MS. Infecciones respiratorias. Clínicas Médicas de Norteamérica. 2001;6:1283-1549.

8. Mandell G, Benneth J, Dolin R. Principles and practice of infectious diseases, 6th. ed. [Philadelphia] : Churchill Livingstone; 2002.

9. Ministerio de salud, Instituto Nacional de Salud. Vigilancia por el laboratorio de Streptococcus pneumoniae aislado de procesos invasores en niños menores de 5 años: actualización de datos 1994-1999. Inf Epidemiol Nac. 2000 May; 5 (9): 131-135.

10. Mandell LA, Marrie TJ, Grossman RF, Chow AW, Hyland RH, Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Disease Society and the Canadian Thoracic Society. Can Respir J. 2000 Sep-Oct;7(5):371-82.

11. Martínez C, Jaimes F, Montúfar F, et al. Proceso de atención y prescripción en neumonía adquirida en la comunidad en hospitales universitarios en Colombia [artículo en Internet] [citado 2006 Jun 15] Disponible en: http://www.encolombia.com/medicina/neumologia/neumologia15403-proceso.htm.

12. Etiology of Community-Acquired Pneumonia. Clin Chest Med. 2005 Mar;26(1):47-55.

13. Hospital de San José. Reporte anual hospitalización Departamento de Medicina Interna. Bogotá: Hospital de San José; 2001 -2002.