Acute community pneumonia: Contribution of microbiological samples in a pulmonology department

Abstract

<bold>Introduction:</bold> Treatment of acute community-acquired pneumonia (CAP) often relies on probabilistic antibiotic therapy. However, in a hospital setting, utilizing bacteriological guidance can mitigate the risk of antibiotic resistance emergence. <bold>Aim:</bold> determine the benefit of microbiological samples in the CAP. <bold>Methods:</bold> A descriptive observational study was conducted including 68 patients hospitalized between 2017 and 2023 for CAP in the pulmonology department D of the Abderrahmane Mami hospital in Ariana. <bold>Results:</bold> The average age was 57.31 years (ranging from 17 to 86 years). A male predominance was noted with a Sex ratio of 1.61. Thirty-five patients were smokers with an average consumption of 25 PA. A germ was isolated in 52.9% of patients. The germs isolated were: pneumococcus (n=9), pseudomonas (n=2) Klebsielle (n=2), E. Coli (n=1), staphylococcus aureus (n=6), Haemophilus (n =5) and intracellular germs (n=3). Fungi were isolated in two cases. Bacteriological samples isolated more than one germ in four cases. Cytobacteriological examination of sputum (CES) was carried out in 86.6% of cases, isolating a germ in 54.23% of cases. Compared to patients without bronchiectasis, CES in patients with bronchiectasis was more performant (9.1% vs 90.9%; p=0.006). Blood cultures were performed in 29.9% of cases, isolating a germ in a quarter of cases. The bacteriological examination in the bronchial fluid was positive in 17.85% of cases. There was no difference between the duration of antibiotic no matter a germ was isolated or not (18.66 days vs 17.44 days). <bold>Conclusion:</bold> Despite the accessibility and performance of the CES, the benefit of bacteriological samples during non-severe CAP remains low.