Author : Coline Courcol
Background : Severe community-acquired pneumonia remains a major cause of mortality. French Guiana is an high infectious exposure geographical area with a risk of emergence of new pathogens, therefore knowledge of microbial ecology of CAP appears essential. The study aimed to describe the microbiological and clinical epidemiology of severe CAP in French Guiana.
Materials and methods : This is a single center retrospective and descriptive study between 1 st January 2011 and 31st December 2015 in the Cayenne Hospital intensive care unit. All included patients were admitted to ICU with CAP as main diagnosis.
Results : 82 patients (mean age 41 ± 20 years old, IGS 2 48 ± 26) were included. 60% had a microbial diagnosis, with associated bacteraemia in 24% of cases : the major part of identified CAP was bacterial (67%) with Streptococcus pneumoniae found in 1/3 of case. A viral aetiology was identified in 22% of cases. According to ATS/IDSA, 73% of CAP were defined severe. A mechanical ventilation use was required for 83% of patients. 30% underwent septic shock upon admission, 51% acute respiratory distress syndrome (ARDS) and 41% acute renal failure. The mortality rate within 28 days was 33% (n = 27).
Conclusion : Severe CAP in French Guiana are mainly S. pneumoniae side, with a viral aetiology that should not be overlooked. A special attention should be paid to young adult’s clinical evaluation, severity of CAP can be undetected in this population.
