Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin, North Central, Nigeria

Afr Health Sci. 2020 Dec;20(4):1655-1668. doi: 10.4314/ahs.v20i4.18.

Abstract

Background: The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality.

Objectives: To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria.

Methods: One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens.

Results: CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB - 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality.

Conclusion: CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment.

Keywords: Community acquired pneumonia; Nigeria; microbiological profile.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology*
  • Cough / etiology
  • Dyspnea / etiology
  • Hospital Mortality
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Pneumonia, Bacterial / diagnosis
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / microbiology*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / virology*
  • Prospective Studies
  • Sputum / microbiology

Substances

  • Anti-Bacterial Agents