Investigation of atypical and viral pneumonia in patients admitted tointensive care units

ABSTRACT Investigation of Atypical Pneumonia and Viral Pneumonia in Patients with Intensive Care Pneumonia Introduction and Aim: Pneumonia plays an important role in both hospital-acquired and community-acquired infections. Empirical treatment has critical prescription in all community-acquired and hospital-acquired pneumonia patients who need intensive care, and treatment should include possible factors. Despite the large number of studies on bacterial agents, few studies have been conducted in our country to detect viral and atypical agents. In this study, we aimed to determine the etiologies of atypical pneumonia and viral pneumonia in patients with pneumonia requiring intensive care and to investigate the effect of mortality. Materials and Methods: We prospectively studied the clinical and laboratory findings and community-acquired pneumonia (TGP) during hospitalization in our hospital Reanimation, Brain Surgery, Neurology, Chest Diseases and Internal Medicine intensive care units between 1 November 2016 and 30 October 2017, also patients over 18 years of age who were diagnosed with hospital acquired pneumonia (HGP) were included. Patients' clinical features were recorded. Sputum or tracheal aspirate samples taken from the patients were sent for standard bacterial culture. Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophiliae, which are atypical pneumonia, and tracheal aspirate or sputum samples were taken for the detection of viral agents. For the detection of L. pneumophiliae, the cultivation was carried out on "Buffered Charcoal Yeast Extract (BCYE)" medium. In addition, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), rhinovirus (RV), enterovirus (EV), parainfluenza virus (PIV), influenzae (InfA), influenza B (InfB), which are the agents of viral pneumonia taken from the same patients, specific DNA / RNA was investigated by in-house multiplex polymerase chain reaction (PZR) method for human bovavirus (HBoV), adenovirus, nasopharynx swab sample. Findings: 200 patients were included in the study. 126 (63%) of the patients were male and 74 (37%) were female. Sixty-five patients (32.5%) had TGP and 135 patients (67.5%) had HGP. 32.5% of the patients had fever, 61% had dyspnea, 56% had tachypnea, 95.5% had purulent sputum, and 7.5% had an increased cough. All patients had infiltration areas on the lung radiograph. One or more bacterial agents were detected in 83 (41.5%) of the patients and M. pneumoniae was detected in 8 (4%). Thirty-one (15.5%) patients were found to be a viral agent, while 15 cases (7.5%) were mixed bacterial-virus. Influenza was detected in 6% of both TGP and HGP cases. No patients had Legionella recurrence. L. pneumoniae and C. pneumoniae PZR were negative in all patients. Mortality rates were observed as 17% in TGP cases, 29.6% in HGP cases, 27.8% in case of detecting bacterial agent, 25.8% in case of detecting viral agent, 26.6% in cases of detecting bacterial-virus mixed agent and 23.2%. Conclusion: Of the atypical pneumonia agents in hospital-acquired pneumonia and TGP patients, only M. pneumoniae was detected in a small number of patients. Influenza, which is an important factor in empiric treatment of viral agents, was found to be rare. Key words: Atypical pneumonia, viral pneumonia, community-acquired pneumonia, hospital-acquired pneumonia, intensive care ABSTRACT Investigation of Atypical Pneumonia and Viral Pneumonia in Patients with Intensive Care Pneumonia Introduction and Aim: Pneumonia plays an important role in both hospital-acquired and community-acquired infections. Empirical treatment has critical prescription in all community-acquired and hospital-acquired pneumonia patients who need intensive care, and treatment should include possible factors. Despite the large number of studies on bacterial agents, few studies have been conducted in our country to detect viral and atypical agents. In this study, we aimed to determine the etiologies of atypical pneumonia and viral pneumonia in patients with pneumonia requiring intensive care and to investigate the effect of mortality. Materials and Methods: We prospectively studied the clinical and laboratory findings and community-acquired pneumonia (TGP) during hospitalization in our hospital Reanimation, Brain Surgery, Neurology, Chest Diseases and Internal Medicine intensive care units between 1 November 2016 and 30 October 2017, also patients over 18 years of age who were diagnosed with hospital acquired pneumonia (HGP) were included. Patients' clinical features were recorded. Sputum or tracheal aspirate samples taken from the patients were sent for standard bacterial culture. Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophiliae, which are atypical pneumonia, and tracheal aspirate or sputum samples were taken for the detection of viral agents. For the detection of L. pneumophiliae, the cultivation was carried out on "Buffered Charcoal Yeast Extract (BCYE)" medium. In addition, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), rhinovirus (RV), enterovirus (EV), parainfluenza virus (PIV), influenzae (InfA), influenza B (InfB), which are the agents of viral pneumonia taken from the same patients, specific DNA / RNA was investigated by in-house multiplex polymerase chain reaction (PZR) method for human bovavirus (HBoV), adenovirus, nasopharynx swab sample. Findings: 200 patients were included in the study. 126 (63%) of the patients were male and 74 (37%) were female. Sixty-five patients (32.5%) had TGP and 135 patients (67.5%) had HGP. 32.5% of the patients had fever, 61% had dyspnea, 56% had tachypnea, 95.5% had purulent sputum, and 7.5% had an increased cough. All patients had infiltration areas on the lung radiograph. One or more bacterial agents were detected in 83 (41.5%) of the patients and M. pneumoniae was detected in 8 (4%). Thirty-one (15.5%) patients were found to be a viral agent, while 15 cases (7.5%) were mixed bacterial-virus. Influenza was detected in 6% of both TGP and HGP cases. No patients had Legionella recurrence. L. pneumoniae and C. pneumoniae PZR were negative in all patients. Mortality rates were observed as 17% in TGP cases, 29.6% in HGP cases, 27.8% in case of detecting bacterial agent, 25.8% in case of detecting viral agent, 26.6% in cases of detecting bacterial-virus mixed agent and 23.2%. Conclusion: Of the atypical pneumonia agents in hospital-acquired pneumonia and TGP patients, only M. pneumoniae was detected in a small number of patients. Influenza, which is an important factor in empiric treatment of viral agents, was found to be rare. Key words: Atypical pneumonia, viral pneumonia, community-acquired pneumonia, hospital-acquired pneumonia, intensive care ABSTRACT Investigation of Atypical Pneumonia and Viral Pneumonia in Patients with Intensive Care Pneumonia Introduction and Aim: Pneumonia plays an important role in both hospital-acquired and community-acquired infections. Empirical treatment has critical prescription in all community-acquired and hospital-acquired pneumonia patients who need intensive care, and treatment should include possible factors. Despite the large number of studies on bacterial agents, few studies have been conducted in our country to detect viral and atypical agents. In this study, we aimed to determine the etiologies of atypical pneumonia and viral pneumonia in patients with pneumonia requiring intensive care and to investigate the effect of mortality. Materials and Methods: We prospectively studied the clinical and laboratory findings and community-acquired pneumonia (TGP) during hospitalization in our hospital Reanimation, Brain Surgery, Neurology, Chest Diseases and Internal Medicine intensive care units between 1 November 2016 and 30 October 2017, also patients over 18 years of age who were diagnosed with hospital acquired pneumonia (HGP) were included. Patients' clinical features were recorded. Sputum or tracheal aspirate samples taken from the patients were sent for standard bacterial culture. Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophiliae, which are atypical pneumonia, and tracheal aspirate or sputum samples were taken for the detection of viral agents. For the detection of L. pneumophiliae, the cultivation was carried out on "Buffered Charcoal Yeast Extract (BCYE)" medium. In addition, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), rhinovirus (RV), enterovirus (EV), parainfluenza virus (PIV), influenzae (InfA), influenza B (InfB), which are the agents of viral pneumonia taken from the same patients, specific DNA / RNA was investigated by in-house multiplex polymerase chain reaction (PZR) method for human bovavirus (HBoV), adenovirus, nasopharynx swab sample. Findings: 200 patients were included in the study. 126 (63%) of the patients were male and 74 (37%) were female. Sixty-five patients (32.5%) had TGP and 135 patients (67.5%) had HGP. 32.5% of the patients had fever, 61% had dyspnea, 56% had tachypnea, 95.5% had purulent sputum, and 7.5% had an increased cough. All patients had infiltration areas on the lung radiograph. One or more bacterial agents were detected in 83 (41.5%) of the patients and M. pneumoniae was detected in 8 (4%). Thirty-one (15.5%) patients were found to be a viral agent, while 15 cases (7.5%) were mixed bacterial-virus. Influenza was detected in 6% of both TGP and HGP cases. No patients had Legionella recurrence. L. pneumoniae and C. pneumoniae PZR were negative in all patients. Mortality rates were observed as 17% in TGP cases, 29.6% in HGP cases, 27.8% in case of detecting bacterial agent, 25.8% in case of detecting viral agent, 26.6% in cases of detecting bacterial-virus mixed agent and 23.2%. Conclusion: Of the atypical pneumonia agents in hospital-acquired pneumonia and TGP patients, only M. pneumoniae was detected in a small number of patients. Influenza, which is an important factor in empiric treatment of viral agents, was found to be rare. Key words: Atypical pneumonia, viral pneumonia, community-acquired pneumonia, hospital-acquired pneumonia, intensive care