Identification of bacterial isolates and clinical profile in slow resolving pneumonia in patients attending tertiary care hospital, Lahore

Abstract

Background:

Pulmonary physicians often face the dilemma of treating slow resolution pneumonia in-spite of using empirical antibiotics. Slow resolution pneumonia can be due to resistant strains, unusual and highly virulent organisms, inadequate antibiotic therapy, impaired host defenses, and co-morbidities. This study was conducted to identify the bacteria responsible for slow resolving pneumonia in adult patients.  

Patients and Methods: This descriptive cross-sectional study was conducted in pulmonology department of tertiary care hospital in Lahore, Pakistan. A total of 138 adult patients with presumptive diagnosis of pneumonia, not showing any clinical improvement in spite of 10-14 days treatment with combination of antibiotics were included. Patients with atypical pneumonia and nosocomial pneumonia were excluded. Blood and Sputum samples of all the patients were evaluated for gram staining and culture sensitivity in addition to chest x-ray, CT scan and complete blood count. Data was collected by convenient sampling technique and analysis done using SPSS-24 to reach the conclusion.

Results: Out of 138 cases, 80% of the patients fall in age group of 21 to 60 years. Male to female ratio was 1.7:1. Frequency of clinical features includes cough in 96.4%, fever 91.3%, expectoration 87%, weight loss 83.3% and dyspnea 77.5% of cases.  Gram negative bacteria were isolated in 94 (68.11%) patients and Pseudomonas Aeruginosa was the most common bacteria in this group while gram positive bacteria were present in 25 (18.11%) patients with Strep. Pneumonia predominance.

Conclusions:  Gram negative bacteria are the commonest reason for slow resolution in pneumonia.

Key words:  Bacteria, Etiology, Gram negative, Gram positive, Pneumonia, Slow Resolving.