The aetiological agents in adult patients with community-acquired lower respiratory tract infections in Turkey

Abstract number: 1733_695

Koksal I., Ozlu T., Bayraktar Saral O., Aydin K., Caylan R., Oztuna F., Bulbul Y., Yilmaz G., Sucu N., the Pneumonia Study Group and Turkey 

Objectives: Lower respiratory-tract infections, community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease (COPD), is recognized as a major cause of morbidity, mortality, and antibiotic use in the community. The microbiologic agents of CAP and COPD vary considerably not only worldwide, but regionally as well.

In this study, it is aimed to investigate typical and atypical aetiological agents of community-acquired lower respiratory-tract infections.

Methods: The study which was led by Karadeniz Technical University was conducted prospectively between November 2003 and March 2005. Eight universities hospitals from seven different geographical regions of Turkey participated in this study. Sputum, nasopharyngeal aspirate, blood and urinary samples were taken from the 218 patients diagnosed lower respiratory-tract infections clinically and radiologically. The samples were inspected by culturing, Gram's stains and immunofluorescence methods.

Results: Aetiological agents were identified in the 62.8% of the patients. While 24.3% of them were typical, 26.6% were atypical and 11.9% mix agents. Major pathogens identified in lower respiratory-tract infections were %23.4 S. pneumoniae, 21.9% M. pneumoniae, and 16% RSV. 37.6% of the cases were in the winter, 30.3% in the spring. 56.9% of the patients were under age 65. While 29.1% S. pneumoniae, 23.6% RSV and 14.5% M. pneumoniae were identified in the patients above age 65, 26.8% M. pneumoniae, 19.5% S. pneumoniae, 10.9% H. influenzae and 10.9% RSV identified in those under the age of 65. While the major pathogens in CAP were 24.4% M. pneumoniae, 20.9% S. pneumoniae and 10.4% RSV, those in COPD were 27.4% S. pneumoniae, 25.5% RSV, 17.6% M. pneumoniae and 17.6% H. influenzae.

Conclusion: When the lower respiratory-tract infection agents were inspected, S. pneumoniae, M. pneumoniae and RSV were found out in the first three positions. Most of the cases are seen in the winter. CAP and COPD agents are similar. S. pneumoniae is, by the ratio of 23.4%, the most frequent agent.