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VOLUME 61 , ISSUE 3 ( July-September, 2019 ) > List of Articles

Original Article

Clinical and Microbiological Profile of Patients with Pneumonia Admitted to the ICU of a Tertiary Care Hospital in Southern Rajasthan

Harshil Pandya, Atul Luhadia, Shanti Kumar Luhadia, Rishi Kumar Sharma, Gaurav Chhabra, Shubhkaran Sharma, Mayank Kapur, Rahul Kumar

Keywords : Pneumonia, Intensive care unit, Anti-biogram

Citation Information : Pandya H, Luhadia A, Luhadia SK, Sharma RK, Chhabra G, Sharma S, Kapur M, Kumar R. Clinical and Microbiological Profile of Patients with Pneumonia Admitted to the ICU of a Tertiary Care Hospital in Southern Rajasthan. Indian J Chest Dis Allied Sci 2019; 61 (3):123-128.

DOI: 10.5005/ijcdas-61-3-123

License: CC BY-NC 4.0

Published Online: 18-11-2022

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Background: Lower respiratory tract infection (LRTI) is an acute illness (presenting for 21 days or less), usually with cough as the main symptom, and with at least one other lower respiratory tract symptom, such as fever, sputum production, breathlessness, wheeze, chest discomfort or pain. Out of the LRTIs, pneumonia is the most common. This study was conducted to determine the clinical profile of pneumonia in a medical and respiratory intensive care unit (ICU) of a tertiary care hospital, to identify different micro-organisms in respiratory samples of the patients and pattern of antibiotic susceptibility and to develop antibiogram charts for starting empirical therapy in the ICU. Methods: Patients admitted to the Medical and Respiratory ICUs of Geetanjali Medical College and Hospital, Udaipur (Rajasthan), India during January 2016 to October 2017 were included in this study. CURB-65 (Confusion, urea, respiratory rate, blood pressure plus age ≥65 years) score was retrospectively evaluated in the admitted patients. Results: Out of 84 patients, most (81%) were males, smokers (73%) and above 65 years of age. Most common co-morbidity was chronic obstructive pulmonary disease (COPD) (n=47, 56%) and most common symptom was cough (84%). Chest radiograph revealed multi-lobar involvement as the most common finding. Commonest organism isolated in our study was Pseudomonas (n=24, 29%). Pseudomonas aeruginosa (n=13, 41%) was the commonest organism found in previously hospitalised patients, whereas Streptococcus pneumoniae (n=12, 23%) was the commonest organism found in previously non-hospitalised patients. Most of the Gram-negative isolates were sensitive to colistin (97%). Vancomycin showed highest activity (100%) against Grampositive isolates. Conclusions: The most common pathogen in patients with pneumonia admitted to ICU in our area was Streptococcus pneumonia in routine patients and Pseudomonas aeruginosa in previously hospitalised patients. For the effective management of pneumonia, detailed bacteriological diagnosis and susceptibility testing, and local anti-biogram are required in view of the global problem of antibiotic resistance.


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