Microbial pathogens of adult community-acquired pneumonia in Southern Estonia

Medicina (Kaunas). 2006;42(5):384-94.


Prospective analysis of the etiology of community-acquired pneumonia in 209 inpatients (mean age 56.2+/-11.2 years) was performed at the Lung Hospital of Tartu University, Estonia. Majority of the patients (87.6%) had at least one significant modifying or risk factor and 30.6% had severe community-acquired pneumonia. Streptococcus pneumoniae, beta-hemolytic streptococci, Klebsiella pneumoniae, and Moraxella catarrhalis were the most frequent pathogens (22.0, 12.2, 11.4, and 10.2%, respectively). Combined etiology was detected in 17.2%. Gram-negative pathogens prevailed over gram-positives and were significantly more frequent in patients aged > or =60 years (p=0.002) as in those with underlying diseases (p=0.01). An age of > or =60 years and previous antibacterial therapy were significant risk factors for Klebsiella pneumoniae as a pathogen (p=0.005 and p=0.002, respectively). Susceptibility of Streptococcus pneumoniae to penicillin, erythromycin, and doxycycline was 79.5, 90.2, and 100%, respectively, whereas all penicillin-resistant isolates were cefuroxime- and ceftriaxone-susceptible. Klebsiella pneumoniae was 100, 88.5, 84.2, and 81.8% susceptible to ceftazidime, gentamicin, ampicillin-sulbactam, and ciprofloxacin, and Moraxella catarrhalis was 100, 100, 100, 93.8, and 93.3% susceptible to ampicillin-sulbactam, cephalexin, ceftriaxone, ciprofloxacin, and erythromycin, respectively. In conclusion, Streptococcus pneumoniae, Moraxella catarrhalis, and Klebsiella pneumoniae were the major pathogens of community-acquired pneumonia in Southern Estonia. Although gram-negatives were more prevalent, the major pathogens were favorably susceptible without a noticeable cross-resistance. Nevertheless, improved surveillance studies are needed because of a pressure for the rise in antibiotic resistance in the society.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Bacteria / drug effects*
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Data Interpretation, Statistical
  • Drug Resistance, Bacterial
  • Estonia
  • Female
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Klebsiella pneumoniae / drug effects
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Moraxella catarrhalis / drug effects
  • Penicillin Resistance
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / microbiology*
  • Pneumonia, Pneumococcal / drug therapy
  • Pneumonia, Pneumococcal / microbiology
  • Prospective Studies
  • Risk Factors
  • Streptococcus pneumoniae / drug effects


  • Anti-Bacterial Agents