The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape

Arlene Mazaza, Usha Lalla, Jantjie J Taljaard, Thadathilankal Jess John, Kiran George John, Johannes Slabbert, Coenraad FN Koegelenberg




Community-acquired pneumonia (CAP) is a common condition, with mortality increasing in patients who require intensive care unit (ICU) admission. A better understanding of the current aetiology of severe CAP will aid clinicians in requesting appropriate diagnostic tests and initiating appropriate empiric antimicrobials.Aim


The objectives of this study were to assess the comorbidities, aetiology and mortality associated with severe CAP in a tertiary ICU in Cape Town, South Africa.Methods


We retrospectively analysed a prospective registry of all adults admitted to the medical intensive care unit at Tygerberg Hospital with severe CAP over a one-year period.Results


We identified 74 patients (age 40.0 +/-15.5 years, 44 females). The patients had a mean APACHE II score of 21.4 +/- 7.9, and the mean ICU stay was 6.6 days. Of the 74 patients, 16 (21.6%) died in ICU. Non-survivors had a higher APACHE II score than survivors (28.3 +/- 6.8 vs. 19.4 +/- 7.1, p


Mycobacterium tuberculosis was the single most common agent identified in patient presenting with CAP. The relatively high percentage of confirmed community acquired Pseudomonas aeruginosa could possibly be related to the concomitant severe drought experienced at the time of the study. The mortality of CAP requiring invasive ventilation was relatively low, with a strong association between mortality a higher APACHE II score.

Authors' affiliations

Arlene Mazaza, Stellenbosch University

Usha Lalla, Stellenbosch University

Jantjie J Taljaard, Stellenbosch University

Thadathilankal Jess John, Stellenbosch University

Kiran George John, Stellenbosch University

Johannes Slabbert, Department of Medical Microbiology

Coenraad FN Koegelenberg, Stellenbosch University

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African Journal of Thoracic and Critical Care Medicine 2020;26(1):5-7. DOI:10.7196/AJTCCM.2020.v26i1.035

Article History

Date submitted: 2020-03-19
Date published: 2020-03-19

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