Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait

N. Behbehani, A. Mahmood, E. M. Mokaddas, Z. Bittar, B. Jayakrishnan, M. Khadadah, A. S. Pacsa, R. Dhar, T. D. Chugh

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. Subjects and Methods: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. Results: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 ± 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients (35%), with one pathogen in 31 (25%), two in 9 (7%), and three or more in 4 (3%). The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients (11%), Legionella pneumophila in 10 (8%), Chlamydia pneumoniae in 8 (6%), influenza B virus in 8 (6%), influenza A virus in 5 (4%), Haemophilus influenzae in 4 (3%), Streptococcus pneumoniae in 3 (2%), Staphylococcus aureus in 3 (2%), gram-negative enterobacteria in 5 (4%), Moraxella catarrhalis in 2 (2%), and viruses in 4 (3%). The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Conclusion: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalMedical Principles and Practice
Volume14
Issue number4
DOIs
Publication statusPublished - Jul 2005

Fingerprint

Kuwait
Pneumonia
Influenza B virus
Moraxella (Branhamella) catarrhalis
Legionella pneumophila
Chlamydophila pneumoniae
Mycoplasma pneumoniae
Influenza A virus
Macrolides
Haemophilus influenzae
Serologic Tests
Enterobacteriaceae
Serology
Streptococcus pneumoniae
Sputum
Staphylococcus aureus
Outcome Assessment (Health Care)
Viruses
Bacteria
Population

Keywords

  • Etiology
  • Pneumonia, severity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait. / Behbehani, N.; Mahmood, A.; Mokaddas, E. M.; Bittar, Z.; Jayakrishnan, B.; Khadadah, M.; Pacsa, A. S.; Dhar, R.; Chugh, T. D.

In: Medical Principles and Practice, Vol. 14, No. 4, 07.2005, p. 235-240.

Research output: Contribution to journalArticle

Behbehani, N, Mahmood, A, Mokaddas, EM, Bittar, Z, Jayakrishnan, B, Khadadah, M, Pacsa, AS, Dhar, R & Chugh, TD 2005, 'Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait', Medical Principles and Practice, vol. 14, no. 4, pp. 235-240. https://doi.org/10.1159/000085741
Behbehani, N. ; Mahmood, A. ; Mokaddas, E. M. ; Bittar, Z. ; Jayakrishnan, B. ; Khadadah, M. ; Pacsa, A. S. ; Dhar, R. ; Chugh, T. D. / Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait. In: Medical Principles and Practice. 2005 ; Vol. 14, No. 4. pp. 235-240.
@article{06f445245bd0406ca7f785639b934d2a,
title = "Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait",
abstract = "Objectives: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. Subjects and Methods: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. Results: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 ± 18 years. The severity class distribution was: class 131{\%}, class II 37{\%}, class III 17{\%}, class IV 13{\%}, and class V 2{\%}. Etiological agents were identified from 44 patients (35{\%}), with one pathogen in 31 (25{\%}), two in 9 (7{\%}), and three or more in 4 (3{\%}). The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients (11{\%}), Legionella pneumophila in 10 (8{\%}), Chlamydia pneumoniae in 8 (6{\%}), influenza B virus in 8 (6{\%}), influenza A virus in 5 (4{\%}), Haemophilus influenzae in 4 (3{\%}), Streptococcus pneumoniae in 3 (2{\%}), Staphylococcus aureus in 3 (2{\%}), gram-negative enterobacteria in 5 (4{\%}), Moraxella catarrhalis in 2 (2{\%}), and viruses in 4 (3{\%}). The yields from laboratory tests were 48{\%} for paired serology, 20{\%} from adequate sputum sample, and 3{\%} from blood culture. Conclusion: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides.",
keywords = "Etiology, Pneumonia, severity",
author = "N. Behbehani and A. Mahmood and Mokaddas, {E. M.} and Z. Bittar and B. Jayakrishnan and M. Khadadah and Pacsa, {A. S.} and R. Dhar and Chugh, {T. D.}",
year = "2005",
month = "7",
doi = "10.1159/000085741",
language = "English",
volume = "14",
pages = "235--240",
journal = "Medical Principles and Practice",
issn = "1011-7571",
publisher = "S. Karger AG",
number = "4",

}

TY - JOUR

T1 - Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait

AU - Behbehani, N.

AU - Mahmood, A.

AU - Mokaddas, E. M.

AU - Bittar, Z.

AU - Jayakrishnan, B.

AU - Khadadah, M.

AU - Pacsa, A. S.

AU - Dhar, R.

AU - Chugh, T. D.

PY - 2005/7

Y1 - 2005/7

N2 - Objectives: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. Subjects and Methods: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. Results: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 ± 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients (35%), with one pathogen in 31 (25%), two in 9 (7%), and three or more in 4 (3%). The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients (11%), Legionella pneumophila in 10 (8%), Chlamydia pneumoniae in 8 (6%), influenza B virus in 8 (6%), influenza A virus in 5 (4%), Haemophilus influenzae in 4 (3%), Streptococcus pneumoniae in 3 (2%), Staphylococcus aureus in 3 (2%), gram-negative enterobacteria in 5 (4%), Moraxella catarrhalis in 2 (2%), and viruses in 4 (3%). The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Conclusion: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides.

AB - Objectives: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. Subjects and Methods: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. Results: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 ± 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients (35%), with one pathogen in 31 (25%), two in 9 (7%), and three or more in 4 (3%). The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients (11%), Legionella pneumophila in 10 (8%), Chlamydia pneumoniae in 8 (6%), influenza B virus in 8 (6%), influenza A virus in 5 (4%), Haemophilus influenzae in 4 (3%), Streptococcus pneumoniae in 3 (2%), Staphylococcus aureus in 3 (2%), gram-negative enterobacteria in 5 (4%), Moraxella catarrhalis in 2 (2%), and viruses in 4 (3%). The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Conclusion: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides.

KW - Etiology

KW - Pneumonia, severity

UR - http://www.scopus.com/inward/record.url?scp=20844452461&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20844452461&partnerID=8YFLogxK

U2 - 10.1159/000085741

DO - 10.1159/000085741

M3 - Article

VL - 14

SP - 235

EP - 240

JO - Medical Principles and Practice

JF - Medical Principles and Practice

SN - 1011-7571

IS - 4

ER -