Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin, North Central, Nigeria.

Ojuawo, Olutobi Babatope; Desalu, Olufemi Olumuyiwa; Fawibe, Ademola Emmanuel; Ojuawo, Ayotade Boluwatife; Aladesanmi, Adeniyi Olatunji; Opeyemi, Christopher Muyiwa; Adio, Mosunmoluwa Obafemi; Jimoh, Abdulraheem Olayemi; Amadu, Dele Ohinoyi; Fadeyi, Abayomi; Salami, Kazeem Alakija

Background The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality. Objectives To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria. Methods One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens. Results CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB - 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality. Conclusion CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment.