Predisposing Factors of Pseudomonas Pneumonia: A Hospital Based Cross-sectional Study

Abstract

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is a usual causative organism of both hospital-acquired pneumonia and community-acquired pneumonia. Although, it is less commonly reported in otherwise healthy hosts, most patients have an identifiable risk factor for disease. These risk factors include those with structural lung abnormalities like bronchiectasis and those with a compromised immune system. With the emergence of multidrug resistant strains of P. aeruginosa, the severity of infection and mortality associated with pneumonia has increased drastically. The insight into the risk factors of Pseudomonas pneumomia helps to suspect and treat the condition at the earliest and thereby reduce the mortality as well as the duration of hospital stay. Aim: To determine various risk factors associated with P. aeruginosa pneumonia. Materials and Methods: An observational cross-sectional study was conducted from November 2018 to November 2020 at Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, Inida, after obtaining Institutional Ethics Committee (IEC) approval. A total of 89 patients with diagnosis of Pseudomonas pneumonia, defined as the presence of signs and symptoms of pneumonia along with sputum or tracheal culture positive for P. aeruginosa were enrolled in the study. These patients were thoroughly assessed by clinical history, physical examination and relevant investigations to detect any risk factors like age, diabetes, smoking, Chronic Obstructive Pulmonary Disease (COPD), chronic steroid use and prior hospital admission. Data analysis was done using Statistical Package for Social Sciences (SPSS version 22.0). Categorical variables were compared with the Chi-square test. Results: Out of 89 patients with Pseudomonas pneumonia, 77.5% were above 40 years of age, 37.08% were smokers, 25.84% had COPD, 22.47% had bronchiectasis, 31.46% were diabetic, 15.73% were on long term steroid use and 14.61% had history of prior hospital admission. Conclusion: Age, smoking, structural lung diseases like COPD, bronchiectasis, long term steroid use and prior hospital admission are important risk factors for Pseudomonas pneumonia.