Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study

Türkiye de erişkin hastalarda toplum kökenli pnömonilerde etyolojik ajanlar; çok merkezli, kesitsel çalışma

Kemalettin AYDIN, Rahmet ÇAYLAN, Özlem BAYRAKTAR, Nurgün SUCU, İftihar KÖKSAL, Gürdal YILMAZ, Funda ÖZTUNA, Tevfik ÖZLÜ, Yılmaz BÜLBÜL

Özet

Bu kesitsel çalışma öncesinde antibiyotik tedavisi almayan erişkin hastalarda toplum kökenli pnömoniler (TKP)in etyolojisinin araştırılması için tasarlandı. Çalışmaya alınan 218 hastanın 137 (%62.8)sinde etyolojik ajan tespit edildi. En sık tespit edilen ajanlar Streptococcus pneumoniae (%14.7), Mycoplasma pneumoniae (%13.8) ve respiratuar sinsityal virüs (%10.1) idi. Olguların %50.9unda tek patojen, %11.9unda çoklu patojen belirlendi. Olguların %35.8inde tipik patojenler,%20.2sinde atipik patojenler, %20.6sında ise viral patojenler belirlendi. Altta yatan hastalık olarak hastaların %42.7sinde kronik obstrüktif akciğer hastalığı vardı. S. pneumoniae TKPli erişkin hastalarda en yaygın patojendi. Atipik patojenler 65 yaşın altında daha yaygındı. M. pneumoniae bu yaş grubunda en sık etkendi. Çalışmamız, Türkiyede TKPli hastalarda başlangıç antibiyotik tedavisinin, S. pneumoniae ve M. pneumoniaeyı kapsaması gerektiğini göstermektedir.

Abstract

Dilara İnan Özcan, Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Medical Faculty, Antalya/Candan Öğüş, Department of Chest Diseases and Tuberculosis, Akdeniz University Medical Faculty, Antalya/Emin Tekeli, Department of Infectious Diseases and Clinical Microbiology, Ankara University Medical Faculty, Ankara/Akın Kaya, Department of Chest Diseases and Tuberculosis, Ankara University Medical Faculty, Ankara/Celal Ayaz, Department of Infectious Diseases and Clinical Microbiology, Dicle University Medical Faculty, Diyarbakir/Canan Eren Dağlı, Department of Chest Diseases and Tuberculosis, Dicle University Medical Faculty, Diyarbakir/Orhan Yıldız, Department of Infectious Diseases and Clinical Microbiology, Erciyes University Medical Faculty, Kayseri/Fatma Sema Oymak, Department of Chest Diseases and Tuberculosis, Erciyes University Medical Faculty, Kayseri/Ahmet Kalkan, Department of Infectious Diseases and Clinical Microbiology, Firat University Medical Faculty, Elazig/Mehmet Hamdi Muz, Department of Chest Diseases and Tuberculosis, Firat University Medical Faculty, Elazig/Hüseyin Turgut, Department of Infectious Diseases and Clinical Microbiology, Pamukkale University Medical Faculty, Denizli/Fatma Fi- şekçi, Department of Chest Diseases and Tuberculosis, Pamukkale University Medical Faculty, Denizli/Yasemin Heper, Department of Infectious Diseases and Clinical Microbiology, Uludag University Medical Faculty, Bursa/Esra Uzaslan, Department of Chest Diseases and Tuberculosis, Uludag University Medical Faculty, Bursa, Turkey. This cross-sectional study was intended to investigate the etiology of community-acquired pneumonia (CAP) in adult patients receiving no prior antibiotic therapy. Etiological agents were identified in 137 (62.8%) of 218 patients, the most frequent being Streptococcus pneumoniae (14.7%), Mycoplasma pneumoniae (13.8%) and respiratory syncytial virus (10.1%). A single pathogen was detected in 50.9% of cases and mixed pathogens in 11.9%. Typical pathogens were determined in 35.8% of cases, atypical pathogens in 20.2% and viral pathogens in 20.6%. Chronic obstructive pulmonary disease was a common (42.7%) comorbidity. S. pneumoniae was the most common pathogen in adult patients with CAP. Atypical pathogens were more common in patients < 65 years old, M. pneumoniae being the most common in this age group. Our results suggest that initial empiric antibiotic treatment in patients with CAP should cover S. pneumoniae and M. pneumoniae in Turkey.