[Severe community-acquired pneumonia admitted at the intensive care unit: main clinical and bacteriological features and prognostic factors: a Tunisian experience]

Abstract

Introduction: Severe community-acquired pneumonia (SCAP) remains a major cause of death. The aim of this study was to describe the main clinical and bacteriological features and to determine predictive factors for death in patients with SCAP who were admitted in intensive care unit (ICU) in a Tunisian setting.

Method: It is a retrospective study conducted between March 2005 and December 2010 at the intensive care unit of the University Hospital of Mahdia (Tunisia). All patients hospitalized at the ICU with a SCAP diagnosis according to the American Thoracic Society criteria were included.

Results: Two hundred and nine patients (mean age: 64±16 years, and mean SAPS II: 42±17) were included. Overall, 24% had a bacteriological diagnosis. Streptococcus pneumoniae was the most frequently detected. Use of mechanical ventilation was required in 57% of patients and 45% experimented septic shock upon admission. The mortality rate at ICU was 29% (n=60). In multivariate analysis, a septic shock at admission and the use of mechanical ventilation were both associated with death.

Conclusion: SCAP were associated with high mortality in the ICU.

Keywords: Epidemiology; Facteurs pronostiques; Intensive care; Mortality; Mortalité; Pneumopathies communautaires sévères; Prognostic factors; Réanimation; Severe community-acquired pneumonia; Épidémiologie.