Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile

Background: Community-acquired pneumonia (CAP) is a common and serious illness in Chile. Aim: To evaluate the etiology, severity, prognostic factors and blood culture yield of CAP requiring hospitalization in Puerto Montt in Southern, Chile. Patients and methods: All non immunocompromised adults wit...

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Autores principales:	Riquelme O,Raúl, Riquelme O,Mauricio, Rioseco Z,María Luisa, Gómez M,Valeria, Gil D,Rodrigo, Torres M,Antonio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2006
Materias:	Haemophilus influenzae Penicillin resistance Pneumonia, bacterial Streptococcus pneumoniae
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500008
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spelling	oai:scielo:S0034-988720060005000082006-06-22Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, ChileRiquelme O,RaúlRiquelme O,MauricioRioseco Z,María LuisaGómez M,ValeriaGil D,RodrigoTorres M,Antonio Haemophilus influenzae Penicillin resistance Pneumonia, bacterial Streptococcus pneumoniae Background: Community-acquired pneumonia (CAP) is a common and serious illness in Chile. Aim: To evaluate the etiology, severity, prognostic factors and blood culture yield of CAP requiring hospitalization in Puerto Montt in Southern, Chile. Patients and methods: All non immunocompromised adults with CAP admitted at Puerto Montt Hospital during one year, were prospectively studied. Clinical and radiological assessment was done in all patients. Blood and sputum cultures were obtained and serology for atypical agents was determined. Results: We studied 200 patients, aged 63±19 years (109 males). The prognostic factors associated with mortality were an age over 65 years, an altered mental status, shock and acute renal failure. Etiology was demonstrated in 29% of patients. The most frequent pathogens were Streptococcus pneumoniae (40.7%), Haemophilus influenzae (23.7%) and Chlamydia pneumoniae (16.9%). Mixed infections were found in 17%. Fifteen atypical pathogens were identified in 12 patients. Of these only two received a specific treatment but no one died and their length hospital stay was similar than in the rest of the patients. Overall, blood cultures were positive in 12.5% of patients, but among alcoholics, 58% were positive. In only one percent of cases, positive cultures motivated therapeutic changes among clinicians. Eight percent of S pneumoniae strains were penicillin resistant. Conclusions: Atypical agents were a common cause of CAP in this group of patients, but their pathogenic role and treatment requirements are debatable. Focusing blood cultures on specific groups could improve their yield. The rate of Penicillin resistance for S pneumoniae wasinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.134 n.5 20062006-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500008es10.4067/S0034-98872006000500008
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Haemophilus influenzae Penicillin resistance Pneumonia, bacterial Streptococcus pneumoniae
spellingShingle	Haemophilus influenzae Penicillin resistance Pneumonia, bacterial Streptococcus pneumoniae Riquelme O,Raúl Riquelme O,Mauricio Rioseco Z,María Luisa Gómez M,Valeria Gil D,Rodrigo Torres M,Antonio Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
description	Background: Community-acquired pneumonia (CAP) is a common and serious illness in Chile. Aim: To evaluate the etiology, severity, prognostic factors and blood culture yield of CAP requiring hospitalization in Puerto Montt in Southern, Chile. Patients and methods: All non immunocompromised adults with CAP admitted at Puerto Montt Hospital during one year, were prospectively studied. Clinical and radiological assessment was done in all patients. Blood and sputum cultures were obtained and serology for atypical agents was determined. Results: We studied 200 patients, aged 63±19 years (109 males). The prognostic factors associated with mortality were an age over 65 years, an altered mental status, shock and acute renal failure. Etiology was demonstrated in 29% of patients. The most frequent pathogens were Streptococcus pneumoniae (40.7%), Haemophilus influenzae (23.7%) and Chlamydia pneumoniae (16.9%). Mixed infections were found in 17%. Fifteen atypical pathogens were identified in 12 patients. Of these only two received a specific treatment but no one died and their length hospital stay was similar than in the rest of the patients. Overall, blood cultures were positive in 12.5% of patients, but among alcoholics, 58% were positive. In only one percent of cases, positive cultures motivated therapeutic changes among clinicians. Eight percent of S pneumoniae strains were penicillin resistant. Conclusions: Atypical agents were a common cause of CAP in this group of patients, but their pathogenic role and treatment requirements are debatable. Focusing blood cultures on specific groups could improve their yield. The rate of Penicillin resistance for S pneumoniae was
author	Riquelme O,Raúl Riquelme O,Mauricio Rioseco Z,María Luisa Gómez M,Valeria Gil D,Rodrigo Torres M,Antonio
author_facet	Riquelme O,Raúl Riquelme O,Mauricio Rioseco Z,María Luisa Gómez M,Valeria Gil D,Rodrigo Torres M,Antonio
author_sort	Riquelme O,Raúl
title	Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
title_short	Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
title_full	Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
title_fullStr	Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
title_full_unstemmed	Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile
title_sort	etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, puerto montt, chile
publisher	Sociedad Médica de Santiago
publishDate	2006
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500008
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Etiologíay factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile

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