MICROBIAL PROFILE ANALYSIS OF ASPIRATION PNEUMONIA PATIENTS, IDENTIFYING COMMON ORGANISMS AND THEIR CLINICAL IMPLICATIONS

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Fawad Alam
Sabina Afzal
Muhammad Ijlal Naseer
Abdul Hameed
Muhammad Latif
Sohail Ahmad
Faizan Ahmad
Nasir Ali
Naqeeb Ullah
Ruknud Din
Ayiz Jan
Sundas Safdar
Zubair Ahmad

Keywords

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Abstract

Aspiration pneumonia denotes a lung infection resulting from the inhalation of foreign materials, including food particles, saliva, or liquids, into the lungs. This condition primarily arises from accidental aspiration during swallowing, vomiting, or regurgitation. Common symptoms encompass coughing, breathing difficulties, chest discomfort, fever, and, in severe cases, necessitates medical intervention due to potential complications. The condition predominantly affects individuals with impaired swallowing reflexes, neurological disorders, or those who are unconscious. Treatment typically involves antibiotics to address the infection and supportive measures for symptom management. The current study was carried out to determine microbial profile of aspiration pneumonia patients, identifying common organisms and their clinical implications.


Materials and Methods: This prospective study was conducted at the department of pulmonology and medicine at Lady Reading Hospital, Peshawar from January 2021 to October 2023. A total of 138 patients with suspected aspiration pneumonia, aged 65 years and older, admitted from the emergency department were included. Blood cultures were carried in all participants.  For the investigation of Legionella pneumophila urine samples were examined, pneumococcus antigens were employed and in the first four hours respiratory specimens were collected for the study.  Bacterial growth greater than 103 cfu/ml and positive respiratory assay for influenza A and B antigens were further processed. Three distinct groups were identified based on bacteriologic findings. An aerobic group conforming patients of pneumonia recognized aerobic microorganisms’. An anaerobic group involving patients with pneumonia who had a protected Broncho alveolar lavage specimen containing at least one anaerobic microorganism. A group of patients with unverified pneumonia in whom the diagnostic workup did not reveal the presence of a microbial pathogen. For data analysis Statistical Analysis System, Kaysville (NCSS) was used. . Students T test was used for comparing Continuous variables. And the Mann-Whitney test was used for non-normally distributed variables. When appropriate, the chi-square test with Yates correction or Fisher's exact test was employed to compare proportions


Results; microbial profile of the current study explored that the most dominant microorganisms from aspiration pneumonia were gram negative bacilli followed by gram positive (S.aureus). The clinical   implications were cough, fever, Delirium and Comorbidities. Mortality rate was most prevalent in this study.


Conclusion; The most frequent bacteria were gram negative bacilli followed by S.aureus and streptococcus pneumonia. ), if we talk about the clinical implications in our study some participants died due to aspiration pneumonia so proper management and antibiotic therapy play a vital role in the prevention of mortality .

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References

1. Mandell LA, Niederman MS. Aspiration Pneumonia. N Engl J Med. 2019 Feb 14;380(7):651-663
2. Cicala G, Barbieri MA, Spina E, de Leon J. A comprehensive review of swallowing difficulties and dysphagia associated with antipsychotics in adults. Expert Rev Clin Pharmacol. 2019 Mar;12(3):219-234.
3. Neill S, Dean N. Aspiration pneumonia and pneumonitis: a spectrum of infectious/noninfectious diseases affecting the lung. Curr Opin Infect Dis. 2019 Apr;32(2):152-157
4. Ishida T, Tachibana H, Ito A, Yoshioka H, Arita M, Hashimoto T. Clinical characteristics of nursing and healthcare-associated pneumonia: a Japanese variant of healthcare-associated pneumonia. Intern Med. 2012;51:2537–4
5. Garcia-Vidal C, Viasus D, Roset A, Adamuz J, Verdaguer R, Dorca J, et al. Low incidence of multidrug-resistant organisms in patients with healthcare associated pneumonia requiring hospitalization. Clin Microbiol Infect. 2011; 17:1659–65
6. David MD, Richard GW. Aspiration pneumonia: a review of modern trends. JCrit Care. 2015;30:40–8
7. Bowerman TJ, Zhang J, Waite LM. Antibacterial treatment of aspiration pneumonia in older people: a systematic review. Clin Interv Aging. 2018;13:2201-2213
8. Liu C, Cao Y, Lin J, Ng L, Needleman I, Walsh T, Li C. Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev. 2018 Sep 27;9(9):CD012416.
9. Wang JL, Chen KY, Fang CT, et al. Changing bacteriology of adult community-acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes. Clin Infect Dis. 2005;40:915-922.
10. Johnson JL, Hirsch CS. Aspiration pneumonia. Recognizing and managing a potentially growing disorder. Postgrad Med. 2003 Mar;113(3):99-102, 105-6, 111-2.
11. Lorber B, Swenson RM. Bacteriology of aspiration pneumonia: a prospective study of community and hospital-acquired cases.Ann Intern Med1974;81:329–331
12. Bartlett J, Gorbach SL, Finegold SM. The bacteriology of aspiration pneumonia. AmJMed 1974;56:202–207
13. Horiuchi K, Matsumoto T, Hidaka E, Kasuga E, Sugano M, Oana K, Kawakami Y, Honda T. Isolation and molecular characterization of catalase-negative Staphylococcus aureus from sputum of a patient with aspiration pneumonia. Jpn J Infect Dis. 2012;65(5):439-41.
14. Marik, P. E. "Aspiration pneumonitis and pneumonia: a clinical review." N Engl J Med 344 (2001): 665 672.

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