Bacteriological and clinical profile of community acquired pneumonia in hospitalised children with associated co-morbidity in a tertiary care centre of Western Rajasthan, India

Abstract

Background: Childhood community acquired pneumonia (CAP) is a significant problem in developing countries and confirmation of microbial aetiology is important for individual, as well as public health. However, there is paucity of data from the western part of the Rajasthan, India. The study was conducted to obtain comprehensive insight into the bacteriological and clinical profile of community-acquired pneumonia with associated co-morbidity in children requiring hospitalization. Methods: It was hospital based single centered, observational study. The study enrolled 130 children with CAP over 12 consecutive months from 2013-14, and recorded presenting symptoms, clinical signs, chest radiography and co-morbid conditions. Blood cultures and NPA (nasopharyngeal aspirates) cultures were performed. Results: We enrolled 130 children. NPA and blood cultures yielded bacteria in only 42 (32.3%) and 29 (22.3%) children respectively. The most common organism isolated on blood culture was Staphylococcus aureus (10%) followed by Streptococcus pneumonia (3.1%). The most common organism isolated on nasopharyngeal aspirate culture was Streptococcus pneumonia (18.5%), followed by Streptococcus aureus . Malnutrition (48.7%) was the most common co-morbidity associated with CAP followed by asthma (3.9%). Conclusions: The overall rate of identification of bacterial etiology of community acquired pneumonia was low. S. pneumoniae and S. aureus predominate in NPA and blood respectively. It is reasonable to conclude that S. aureus is the dominant pathogen in CAP in this part of world. Higher rates of isolation of S. pneomoniae from NPA may be because of carrier stage.