PURPOSE: Bacteraemic community-acquired pneumonia (CAP) is a subgroup of CAP with high mortality. Previous studies usually examined the epidermiology and clinical features of a single organism. We examined the prevalence, clinical presentation and seasonal variation of various organisms of bacteraemic CAP in Hong Kong.
METHODS: This is a retrospective study of all bacteraemic CAP in a regional hospital in Hong Kong from July 2000 to June 2005. Types of organisms involved, the clinical features and outcomes were analyzed.
RESULTS: During the five-year study period, 54 episodes of bacteraemic CAP were identified. These represented 1.3% of all episodes of bacteraemia and 7% of all CAP episodes. There were 38 (70.4%) male and mean age was 71.1±12.4 years. The 30-day mortality was 37%. The most common organisms were Streptococcus pneumoniae (SP, N=20, 47.0%), Klebsiella pneumoniae (KP, N=11, 20.4%), and Acinetobacter baumannii (AB, N=10, 18.5%). AB group was different from the other two groups in having significantly more COPD patients (p=0.024), lower total white cell count (p=0.009), lower absolute neutrophil count (p=0.005), and higher absolute lymphocyte count (p=0.002) on presentation. The overall mortality was not different between the 3 groups. The seasonal distribution was different, with SP bacteraemic CAP occurring predominantly in winter, AB bacteraemic CAP being more common in summer, and KP bacteraemic CAP occurring evenly throughout the whole year.
CONCLUSION: AB CAP is an important cause of bacteraemic CAP in Hong Kong, and it occurs more often in hot seasons.
CLINICAL IMPLICATIONS: AB CAP should be recognized as an important cause of severe CAP because antibiotics currently recommended in international CAP treatment guidelines do not cover this organism.
DISCLOSURE: Wah Shing Leung, No Financial Disclosure Information; No Product/Research Disclosure Information