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

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 .