Mortality Risk and Etiologic Spectrum of Community-acquired Pneumonia in Hospitalized Adult Patients.

Background: The etiology of community-acquired pneumonia (CAP) is specific to each region, as proved by numerous studies conducted so far. Knowledge of these data is essential in developing guidelines for antibiotic prescription. Assessment of severity of CAP patients is crucial in determining the risk of mortality and the site of care. Unusual bacterial etiologies may increase the risk of mortality.

Objective: First outcome was the identification of pathogens in CAP patients requiring hospitalization and secondary to determine factors that correlate with increased risk of mortality.

Material And Methods: A prospective study of patients over 18 years of age hospitalized with CAP from whom pathological products were taken (mainly sputum) for bacteriological analysis (microscopy and culture).

Results: 120 patients were evaluated over a period of three years (2008-2010); we could identify a bacterial etiology in 33 cases (27.5%). The most commonly isolated were S. pneumoniae (11 cases), H. influenzae (9 cases) and Gram-negative enteric bacilli (12 cases). The mortality rate was 9.2%, significantly higher in the age group over 65 years and in patients with hypoxemia, impaired consciousness and high CURB 65 score, but the only independent factor for the mortality risk prediction was the presence of confusion on admission.

Conclusions: S. pneumoniae, H. infuenzae and enteric Gram negative bacilli remain the most frequent cause of CAP in hospitalized patients in Romania and the first line of antibiotic treatment should be targeted. The only independent risk factor for mortality risk was the presence of disorders of consciousness on admission.