ImpactU Versión 3.11.2 Última actualización: Interfaz de Usuario: 16/10/2025 Base de Datos: 29/08/2025 Hecho en Colombia
Agentes etiológicos de la Neumonía adquirida en la comunidad (NAC) en pacientes adultos inmunocompetentes que consultan al servicio de urgencias de la Clínica Reina Sofía. Bogotá, 2006-2007
Objective: To establish the etiology of Community Acquired Pneumonia (CAP) in adult immunocompetent patients consulting to the Emergency Room at Clinica Reina Sofia. Material and Methods: 138 patients (p) with CAP that met inclusion criteria and signed informed consent were included. All the patients underwent all the following: clinical examination, chest x-ray, CBC, Sputum samples for Gram, Ziehl Nielsen, KOH and Pneumocystis colorations; Sputum and blood cultures, acute phase serum for Legionella pneumophila S1 IgM antibodies, Mycoplasma pneumoniae, Coxiella burnetti, Chlamydia pneumoniae, Adenovirus, RSV, Influenza A and B, parainfluenza 1, 2, 3; Nasopharyngeal swabs for viral antigens and Urinary Antigen for Legionella pneumophila and S. pneumoniae. Results: From 138 patients, 74 were females (53.6%) and 64 (46.4%) males. They were between 18 and 93-year-old with an average of 61± 19 years, most patients, 74 (53,62%) were over 65 years old. 51 patients (36.95%) had COPD, twelve patients were smokers (8.7%), 72 nonsmokers (52.2%), 48 past smokers (34.8%) and 6 cooked with wood (3.62%). 37patients (26.81%) had vaccination against influenza, 19 patients (13.8%) had pneumococcal vaccination. The average time of evolution was 5.48 ± 3.3 days. The most frequent symptoms were fever (97.82%), cough (83.3%), and shortness of breath (78.98%). Etiological diagnosis was established in 64 patients (46.4%), 12 of them had two germs isolated, for a total of 75 isolates. The first five isolates as single germ, were the following: S. pneumoniae 22 (16%), H. parainfluenzae 5 (3.62%), L. pneumophila 4 (2.9%), S. aureus 3 (2.17%) and H. influenzae 2 (1.45%). Summed together, viruses were responsible for six cases, 5 as single germ and in one case two viruses in association. Viral etiology was the third cause in this series. The blood cultures were positive in 4 (2.9%) patients. Conclusions: the most frequent isolate, both as single or mixed aetiology was S.pneumoniae, followed by atypical germs and viruses. Of importance, we found a low performance of the blood cultures and a high number of L. pneumophila isolates, which must be taken into account to start the first antibiotic therapy