Abstract
The aim: To determine etiological structure of severe CAP (SCAP) in young people in order to improve treatment and prevention methods.
Methods and material: For verification of viruses and bacteria, polymerase chain reaction (PCR) of sputum, enzyme immunoassay (EIA) of blood and immunochromatography tests (ICT) of sputum were used. The number of patients with SCAP - 39. According to the results of etiological diagnostics, 79% of them had viral-bacterial etiology. Bacterial culture of sputum revealed S. Pneumoniaein 2.5 % of cases, S. Aureus and Kl. Pneumonia– in 7.6 %, and H. Influenza – in 5.1 %. Complex PCR analysis of sputum detected the following: S. pneumoniae – 35.8%, H. influenzae – 12.8%, M. pneumoniae – 20.5%, S. aureus – 8.1%, Cl. pneumoniae – 5.1%, andadenoviruses(AV) – 30.7%, influenzaA and B – 16.1% and 4.5%, respiratory syncytial virus (RSV) – 7.8%. Of great significance in diagnostics was EIA of blood, which revealed AV in 60 %, RSV- 55.3%, influenza A –23.6%, M. pneumoniae –25.6%, Cl. pneumoniae –10.2%. Modern ICT showed a lower sensitivity and specificity as compared to PCR and EIA, but they let us determine AV - 12.8%, RSV – 4.5%, influenza A and B – 10% within 15 minutes after the test. The most frequent combinations of infectious agents were: M. pneumoniae + AV - 30%. In cases of estimated mixed viral-bacterial etiology antiviral drugs (ribavirin, oseltamivir) were used in etiotropic therapy, which helped to avoid serious complications and fatalities.
Conclusions: with modern methods of diagnostics a significant role of viral and mixed infections in the development of SCAP was established. In case of viral-bacterial SCAP additional etiotropic antiviral therapy is required at early stages of treatment.
- Copyright ©the authors 2016