Study of outbreak of pneumonia in AL-Nasiriya city in 2015

Abstract

A retrospective study of 92 patients admitted to AL-Hussein teaching hospital diagnosed with pneumonia in
winter 2015 and 60 patients admitted in winter 2014 with pneumonia as control group. The age, sex and outcome [death
or well] are recorded for each patients for both group, The presenting symptom for each patient in outbreak 2015 are
recorded. Severity of pneumonia is assessed by CURB-65 and recorded for each patient, x-ray finding are recorded to
patients in outbreak in2015 with result of sputum exam for gram stain and viral PCR in selected patients.
Male to female ratio is 1:1 in outbreak of 2015 while it 0.6:1 in 2014 with significant difference between two groups
and no sex difference in each group,The sex is not a risk factor for pneumonia except liogenella infection which more
common in male. Severity of pneumonia is assessed by CURB-65 and result in 21 patients have score 3 and above
[22%] and 10 have score 0 and 26 have score 1and 22[23%] patient have score 2.According to CURB-65 score ;36
patients no need to admission to hospital but other factor like co-morbid disease, for close up the compliance and
response to treatment, and 22% have severe pneumonia need ICU admission and close monitoring.X-ray finding results
in 40 patients show lobar consolidation, 22 patients showed bronchopneumonia pattern and 30 patients show diffuse
interstitial infiltrate. Lobar opacity usually indicate bacterial infection while diffuse interstitial infiltrate usually
nonbacterial mostly viral infection. Bronchopneumonia may indicate both bacteria and nonbacterial.Sputum for gram
stain done for 22 cases only [two positive for S. pneumonia and the other are negative (no organism) and (throat and
nasopharyngeal swap for REAL-PCR) of onther17 cases suspected to have influenza pneumonia [two are positive for
flu A.]Debate continues over the need to perform a sputum examination with Gram staining in every patient with
community-acquired pneumonia. An American Thoracic Society consensus panel has recommended that a sputum
Gram stain and culture be obtained primarily if an organism that is resistant to the usual empirical treatment regimens is
suspected]