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. 2024 Jun 25;16(6):e63132.
doi: 10.7759/cureus.63132. eCollection 2024 Jun.

A Study on the Etiology and Clinical Manifestations of Community-Acquired Pneumonia in Adults in Western India

Vikram B Vikhe  1 , Ahsan A Faruqi  1 , Rahul S Patil  1 , Harshad Patel  1 , Devansh Khandol  1 , Avani Reddy  1
Affiliations

A Study on the Etiology and Clinical Manifestations of Community-Acquired Pneumonia in Adults in Western India

Vikram B Vikhe et al. Cureus. .

Abstract

Background: Community-acquired pneumonia (CAP) is an acute lung infection affecting the alveoli in individuals who have not had recent exposure to healthcare settings. It is characterized by newly detected pulmonary infiltration on a chest X-ray or computed tomography scan, accompanied by at least two of the following symptoms: a new or worsening cough, shortness of breath, increased sputum production, fever or hypothermia, pleuritic chest pain, hypoxia, confusion, or an abnormal WBC count (either leukopenia or leukocytosis). It is a major contributor to global mortality and morbidity, especially in elderly populations. This study aims to investigate the etiology of CAP in our region and analyze the clinical characteristics of patients diagnosed with CAP.

Methodology: This prospective, hospital-based study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, a 2,011-bed multispecialty hospital. The study included 100 patients over 18 years old, diagnosed with CAP, and hospitalized between January 2023 and January 2024. All patients underwent a thorough clinical assessment, and sputum cultures were collected on the day of admission. Patients under 18 years old, those who had been hospitalized within the preceding two weeks, individuals with pneumonia caused by tuberculosis or aspiration pneumonia, patients with compromised immune systems, and pregnant women were excluded.

Results: The study included 100 patients with a mean age of 53.13 years (±18.31). The most common age group was 59-68 years, which included 25 (25%) cases, followed by the 69-78 year age group with 18 (18%) cases and the 18-28 year age group with 15 (15%) cases. The majority were male, with 61 (61%) cases. Common symptoms included fever in 78 cases (78%), chest pain in 69 cases (69%), dyspnea in 65 cases (65%), and cough in 51 cases (51%). Sputum cultures showed growth in 65 cases (65%), with Klebsiella pneumoniae being the most prevalent pathogen in 28 cases (43%), followed by Streptococcus pneumoniae in 18 cases (28%). Together, these two pathogens accounted for 46 out of 65 positive samples (70%).

Conclusions: This study highlights the clinical profile and rising etiology of K. pneumoniae in CAP in adults in Western India, particularly in the elderly. These findings underscore the need for periodic updates on CAP etiology to inform empirical treatment strategies effectively. Future research should use advanced diagnostics and diverse samples to refine CAP management, with continuous monitoring to update treatment protocols.

Keywords: adult pneumonia; clinical manifestations; community-acquired pneumonia (cap); klebsiella pneumoniae (kp); pneumonia; prospective cohort; pune; sputum culture; streptococcus pneumoniae; western india.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Instituitional Ethics Subcomittee, Dr. D. Y. Patil Medical College, Hospital and Research Centre issued approval IESC/PGS/2022/03. The synopsis was approved by the Institutional Ethics Subcommittee in its meeting held on September 28, 2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow diagram of the study
DPU: Dr. D. Y. Patil University; CAP: community-acquired pneumonia
Figure 2
Figure 2. Pie chart showing the agewise distribution of patients in the study
Figure 3
Figure 3. Clinical manifestations of CAP patients in the study
CAP: community-acquired pneumonia
Figure 4
Figure 4. Pie chart showing the etiological pathogens isolated from the sputum cultures of CAP patients in this study
CAP: community-acquired pneumonia
See this image and copyright information in PMC

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