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Review
. 2024 Jul 6;16(7):e63976.
doi: 10.7759/cureus.63976. eCollection 2024 Jul.

A Systematic Review of Community-Acquired Pneumonia in Indian Adults

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

A Systematic Review of Community-Acquired Pneumonia in Indian Adults

Vikram B Vikhe et al. Cureus. .

Erratum in

Abstract

This systematic review aimed to consolidate findings on the etiology of community-acquired pneumonia (CAP) among Indian adults. We adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Guidelines 2020 and conducted a comprehensive search across databases including PubMed, Scopus-Elsevier, and hand-searched reference lists using key terms such as "Community-Acquired Pneumonia," "CAP," "Indian," and "adults." Articles published between January 2010 and January 2024 were included, with exclusions for studies involving pediatric populations, non-Indian patients, or those published before 2010. From an initial pool of 344 articles, duplicates were removed and titles and abstracts were screened, resulting in nine studies meeting the inclusion criteria. The analysis of pooled data comprising 1,643 Indian adult participants revealed the following pathogen distribution: Streptococcus pneumoniae was the most common organism, accounting for 33% of the cases. This was followed by Klebsiella pneumoniae at 23%, Staphylococcus aureus at 10%, Mycoplasma pneumoniae and Legionella pneumophila each at 7%, and Chlamydia pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa each at 4%. Notably, the review highlights a rising incidence of K. pneumoniae in CAP cases, which is a significant concern and should be considered when treating CAP patients in India. The findings emphasize the importance of comprehensive diagnostic testing, including advanced methods such as bronchoalveolar lavage, urinary antigen tests, serology for atypical pathogens, and enzyme-linked immunosorbent assays, to improve diagnostic yield and guide targeted antibiotic therapy. This review underscores the need for updated empirical treatment guidelines that account for dominant pathogens. Future research should focus on employing advanced diagnostic methods to enhance understanding of CAP etiology.

Keywords: a systematic review; antibiotic resistance (abr); community-acquired pneumonia (cap); empirical antibiotic therapy; india; indian adults; klebsiella pneumoniae (kp); pneumonia; streptococcus pneumoniae.

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Conflict of interest statement

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. PRISMA flowchart of selected articles
CAP, community-acquired pneumonia; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Results of the systematic review
Displaying percentages of isolates
Figure 3
Figure 3. Antibiotic sensitivity pattern
The chart presents a comparative analysis of antibiotic sensitivity among different studies, illustrating the sensitivity percentages of various antibiotics across three different datasets: average sensitivity (grey bars), Menon et al. [13] sensitivity (blue bars), and Kalita et al. [14] sensitivity (orange bars).
See this image and copyright information in PMC

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