Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation

  • Derya Çağlayan Serin Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
  • Hüsnü Pullukçu Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
  • Candan Çiçek Ege University Faculty of Medicine
  • Oğuz Reşat Sipahi Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
  • Sezai Taşbakan Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
  • Sabri Atalay İzmir Tepecik Education and Research Hospital, Tepecik, İzmir, Turkey
Keywords: Adult, community acquired pneumonia, etiology, mixed infection, polymerase chain reaction, respiratory viruses

Abstract

Introduction: Polymerase chain reaction (PCR) method has improved the diagnosis rates for patients with community-acquired pneumonia (CAP). We aimed to evaluate the bacterial and viral etiology of hospitalized CAP cases and compare clinical and laboratory findings of patients with pure bacterial and bacterial and viral (mixed) infections.

Methodology: A total of 55 patients hospitalized with CAP were enrolled into the prospective study between February 2010 and December 2010. Clinical and laboratory follow-up were performed on days 0, 7 and 14. Deep tracheal aspiration samples were examined for bacterial and viral pathogens by multiplex PCR, and standard bacteriological culture method.

Results: The etiological identification rate in 50 patients for bacteria, viruses and mixed virus–bacteria combination by PCR were 62%, 4%, 32%, respectively and 60% in 55 patients by bacterial culture method. Streptococcus pneumoniae concomitant with Haemophilus influenzae (36%) and rhinovirus (16%) was very common, whereas atypical pathogens (only Mycoplasma pneumoniae) were rare (6%). Rhinovirus was the most common viral agent (20%). Recently identified viruses, human coronavirus HKU1 and human bocavirus were not detected except for human metapneumovirus (one case). There was no significant difference in terms of mean age, immune status, leukocyte count, C-reactive protein (CRP) values, hospitalization duration and CURB-65 score between bacterial and mixed viral-bacterial detections. Advanced age (p < 0.01) and higher CURB-65 score (p = 0.01) were found to be associated with increased mortality.

Conclusion: Concomitance of bacterial and viral agents is frequent and resemble with bacterial infections alone. Further studies are needed for the clinical significance of mixed detections.

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Author Biographies

Derya Çağlayan Serin, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
Department of Infectious Diseases and Clinical Microbiology
Hüsnü Pullukçu, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
Department of Infectious Diseases and Clinical Microbiology
Candan Çiçek, Ege University Faculty of Medicine
Department of Microbiology and Clinical Microbiology
Oğuz Reşat Sipahi, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
Department of Infectious Diseases and Clinical Microbiology
Sezai Taşbakan, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey
Department of Chest Diseases
Sabri Atalay, İzmir Tepecik Education and Research Hospital, Tepecik, İzmir, Turkey
Department of Infectious Diseases and Clinical Microbiology
Published
2014-04-15
How to Cite
1.
Çağlayan SerinD, Pullukçu H, Çiçek C, Sipahi OR, Taşbakan S, Atalay S (2014) Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation. J Infect Dev Ctries 8:510-518. doi: 10.3855/jidc.3560
Section
Original Articles