Abstract
Background: Bacterial pneumonia is a major cause of hospitalization. Community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) differ in clinical context, microbiology, and outcomes. This study explored disease severity, inflammatory markers, and intensive-care requirements in hospitalized adults with microbiologically confirmed bacterial pneumonia.
Methods: This prospective observational study included 50 adults at a single tertiary-care centre in Bengaluru, India: 41with CAP and 9 with HAP. C-reactive protein (CRP), serum ferritin, and APACHE II score were assessed on Day 1 andDay 5. Clinical outcomes included ICU admission, oxygen support, non-invasive ventilation, invasive mechanicalventilation, and hospital stay. Sparse categorical comparisons were recalculated using two-sided Fisher’s exact tests.
Results: CAP accounted for 82% and HAP for 18%. No presenting symptom differed significantly between groups. ICU admission occurred in 19/41 (46.3%) CAP and 7/9 (77.8%) HAP cases (p=0.142). Invasive mechanical ventilation was required in 6/41 (14.6%) and 4/9 (44.4%), respectively (p=0.065). Mean hospital stay was reported as 11.2±6.7 days in CAP and 17.8±11.3 days in HAP. CRP and ferritin were not significantly correlated on Day 1 (R²=0.0616; approximate r=0.248, p=0.082) but were positively correlated on Day 5 (R²=0.1448; approximate r=0.381, p=0.006).
Conclusion: HAP patients had numerically greater intensive-care and respiratory-support requirements and longer hospitalization, but the small HAP sample produced imprecise comparisons. Serial CRP may reflect clinical course, but prognostic claims require larger studies with complete serial data and validated multivariable analysis.
Keywords: Bacterial pneumonia, APACHE II, Serum ferritin