Severe community-acquired pneumonia at a tertiary academic hospital in Johannesburg, South Africa

被引:1
|
作者
Venturas, Jacqueline P. [1 ]
Richards, Guy A. [2 ]
Feldman, Charles [1 ]
机构
[1] Univ Witwatersrand, Fac Hlth Sci, Med Sch, Dept Internal Med, Johannesburg, South Africa
[2] Univ Witwatersrand, Fac Hlth Sci, Dept Surg, Div Crit Care, Johannesburg, South Africa
关键词
Comorbidity; Intensive care unit; Microbiology; Outcome; Severe community-acquired pneumonia; INTENSIVE-CARE; MICROBIAL ETIOLOGY; INFECTED PATIENTS; VIRUS INFECTION; MORTALITY; MANAGEMENT; EPIDEMIOLOGY; VALIDATION; INDICATORS; FAILURE;
D O I
10.1016/j.rmed.2024.107823
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: There is a paucity of data from sub-Saharan Africa describing Severe Community Acquired Pneumonia (SCAP), a condition with significant morbidity and mortality. Materials and methods: This was a retrospective, single-centre, observational study of consecutive patients with SCAP admitted to the ICU at Charlotte Maxeke Johannesburg Academic Hospital, in South Africa between 1 July 2007 and 31 May 2019. Pneumonia was categorised as community-acquired if there had been no hospitalization in the preceding 2 weeks. Results: We identified 931 patients, (median age 37 [IQR 30-48] years), with the predominant co-morbidity being HIV co-infection (77.1 %). The median CURB-65 and APACHE II scores were 3 (IQR 2-3) and 18 (IQR 14-23) respectively, and most patients had multilobar consolidation on chest X-ray. Mycobacterium tuberculosis was the most common aetiology, followed by Streptococcus pneumoniae. The latter, and Pneumocystis jirovecii were more common amongst survivors and non-survivors, respectively. ICU mortality was 50.1 % and 85 % of patients required ventilation, mostly invasive mechanical ventilation. Ventilated patients and those requiring inotropic support and/or dialysis were more likely to die. Conclusion: We have described a cohort of patients with SCAP, with a comprehensive overview of all putative microbiological causes, which to our knowledge, is the largest reported in the literature.
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页数:9
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