Browsing by Author "Venturas, Jacqueline Penelope"

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    Evaluation of severe community-acquired pneumonia at Charlotte Maxeke Johannesburg Academic Hospital, 2007-2019
    (2024) Venturas, Jacqueline Penelope
    Severe Community Acquired Pneumonia (SCAP) is associated with significant morbidity and mortality worldwide, and there are a paucity of data relating to infections in South Africa, a country with a high prevalence of HIV co-infection. The aim of this study was to investigate a cohort of HIV-positive and HIV-negative patients with SCAP, who were admitted to ICU at a tertiary hospital in Johannesburg, South Africa. This was a retrospective single-centre observational study. Consecutive patients admitted to the Medical ICU at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 1 July 2007 and 31 May 2019 with a diagnosis of community-acquired pneumonia were included in the study. Patients were identified by using the ICU admission books, electronic discharge summaries and/or clinical case notes. Pneumonia was considered to be community-acquired if there was no hospitalization in the 2 weeks prior to the current admission. After excluding 313 records, the cohort consisted of 931 patients with SCAP. The patients were young (median age 37 [IQR 30-48] years), and the predominant co-morbidity was HIV co-infection (77.1%). The median CURB-65 score was 3 (IQR 2-3), the median APACHE II score was 18 (IQR 14-23) and most patients had multilobar consolidation on chest X-ray. Overall Mycobacterium tuberculosis was the most common microbial aetiology identified amongst both HIV-positive and HIV-negative patients. Streptococcus pneumoniae was more common amongst the patients who lived, whereas infection with Pneumocystis jirovecii was more common amongst patients who died. Overall mortality was high (50.1%), and PLWH had a higher risk of mortality than their HIV-negative counterparts on univariable analysis (OR, 1.61; 95% CI 1.07-2.34; P=0.01). In conclusion, we describe a cohort of patients with SCAP in Johannesburg, an area with high HIV prevalence. To our knowledge, this is the largest ICU cohort of patients with SCAP reported in the literature.