A 3-Year Retrospective Study of Community-Acquired Pneumonia in Kuwait with Emphasis on Microbial Aetiology

Abstract

Background: There has not been any published study on community-acquired pneumonia (CAP) in Kuwait. The aim of this study is to determine the clinical characteristics of adult patients with CAP as well as the microbial aetiology and the treatment of CAP. Methods: A retrospective study of all CAP cases admitted to the three acute care hospitals in Kuwait over a 3-year period, 1993–1995, was done. Results: There were 290 patients identified, mean age 41 ± 19 years, of which 57% were males. The patients were divided into three groups (mild, moderate and severe) according to standard published criteria: mild 27.5%, moderate 61%, and severe 11.5%. The microbial aetiology was identified for only 15% of the total cases, 11.5% of the mild group, 14% of the moderate, and 22.5% of the severe. The most common organisms identified were Streptococcus pneumoniae 32%, Mycoplasma pneumoniae 20%, Haemophilus influenzae 14%, Mycobacterium tuberculosis 11%, gram-negative organisms other than Haemophilus species 11% and others 12%. There were 243 (84%) patients who received a single antibiotic as initial therapy while the rest received a combination of antibiotics. The most common antibiotics used were macrolide 28%, ampicillin 24%, a combination of antibiotic 17%, third-generation cephalosporin 12% and others 19%. Conclusion: The rate of identification of microbial aetiology in CAP is poor in Kuwait. There are 27.5% of the patients who can be classified as mild and probably the majority of them can be treated as out-patients. Based on these results, we have started a prospective study to better evaluate the microbial aetiology of CAP in Kuwait.