Community-Acquired Pneumonia: Importance Of Molecular Methods For Etiological Diagnosis And Clinical Features

Objective: This study aims to make an early identification for the diagnosis of community-acquired pneumonia (CAP), to increase the rate of etiological diagnosis and to distinguish bacterial and viral pathogens with the use of multiplex polymerase chain reaction (PCR) in addition to conventional methods, and to compare cases in the light of clinical and laboratory results.Methods: Ninety two CAP patients who were hospitalized and followed at our hospital between January-November 2013 were included in this study. Conventional culture and multiplex PCR were used to identify the causative microorganisms in the respiratory tract samples of the patients. Demographic data, risk factors, clinical, radiological and laboratory results, treatment and follow-up results of the cases were recorded. Statistical Package for the Social Sciences (SPSS) for Windows. Version 15.0 (SPSS Inc., Chicago, IL, USA) program was used in the analysis of the data.Results: CURB-65 score was determined in >= 2 in 80.4% of the cases and 14.1% was followed in the intensive care unit. Of the patients, 42 (45.7%) were found to have bacterial and 20 (21.7%) were found to have viral agents while in 30 (32.6%) patients an agent could not be demostrated. Bacterial etiology was detected with conventional culture methods in 15 (16.3%) and with multiplex PCR in 42 (45.6%) cases. The difference between them was found to be statistically significant (p<0.001). It was found out that mostly bacterial factors were responsible for the CAP cases which were seen in fall or winter, and the etiology of the cases which were seen in spring and summer could not be determined in general (p<0.05). Variables such as sputum production, sore throat, auscultation findings and corticosteroid use were found to be statistically significant among bacterial, viral and unidentified etiology groups.Conclusions: It was demonstrated that molecular methods are beneficial for the early diagnosis of CAP. It was also thought that early diagnosis of viral etiology can prevent the unnecessary use of antibiotics as well as contributing to the patient management.